Country Vet Gundog Challenge

Entry Form

__________________________________________________________________
Hunter(s) Name(s)

__________________________________________________________________
Address

__________________________________________________________________
City/State/Zip

_________________________________________________________
Phone

_________________________@_______________________________
E-Mail

_________________________________________________________
Dog Name (YOU MUST FILL OUT ONE FORM PER DOG RUNNING)

Division(s) Entering:    Circle One       Pointer      Flusher                  

Saturday ___________ Time preferred

Enclose check payable to Okoboji Game Farm or

Credit Card Payment Info:

Name On Card ________________________________________________

Card Number _________________________________________________

Visa Or Master Card (Circle One)  Expiration Date ____________________

I authorize the host club to charge my card in the amount of $________________

______________________________________(Signature)

 Send form to: Okoboji Game Farm

2757 260th Street, Milford, IA 51351

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