This form can be submitted multiple times if you need to make multiple entries. A copy of each completed entry will be emailed to you for your records.

    Name of Puppy/Young Adult (required):

    Sex (required):MaleFemale

    AKC Registration Number/AKC Litter Number (required):

    Birth Date(required):

    Futurity Litter Number (required):

    Be sure to enter the class which corresponds to your dog’s exact age on the day of the futurity event:
    Futurity Class (required)

    Sire (required):

    Dam (required):

    Breeder(s) (required):

    Owner(s) (required):

    Address (required):

    Telephone Number (required):