NOTIFICATION OF A SHOW LICENCE LENT TO ORGANISERS OF THE EVENT
NAME OF APPLICANT CLUB:
ORG NO.
NAME OF CLUB USING ABOVE CLUB'S LICENCE
("ORGANISERS") If same Club, not required
ORG NO.
TYPE OF SHOW:
CHAMPIONSHIP
NON-CHAMPIONSHIP
OTHER (please indicate) ____________ (i.e. AWC/BWT,BA,APT)
CACIB
FCI SHOW:
CACIAG
(Dates need to be pre-booked with
FCI via KUSA 12 months prior to event)
Please clearly indicate which discipline on each date.
DATE OF SHOW/EVENTS:
DATE OF APPLICATION:
DISCIPLINES ON OFFER:
BREED
OBEDIENCE
WT (CLASSIC)
TT TRIALS
WUD
IPO
DOG JUMPING
CARTING
FLYBALL
FIELD
TRIALS
SHOOTING
RATINGS
HANDLER
CLASSES
AGILITY
5L
APPENDIX
APPLIES
BH
A
C
D
F
G
CIRCLE WHICH
VENUE/s :
FEE TENDERED:
(Ensure you have the correct amount)
R
(to be paid and proof sent with application form)
We, (APPLICANT CLUBS NAME) ________________________________ have made application for a licence to hold a Show/Event as specified above. We have lent
this licence to Organisers of the event who, by their signatures below, jointly and severally undertake to hold and conduct it under and in accordance with and be
bound by the Regulations of the Kennel Union of Southern and hereby subscribe to the requirements of Schedule 3, 4 & 4A of the Constitution of the Kennel Union of
Southern Africa (or the Regulations of the FCI where applicable). They also undertake to guarantee the payment of all prize monies and to undertake to submit to and
accept any decision of the Federal Council or any Committee, Provincial, Breed Council to which the Federal Council may delegate its powers.
NOTE: The signatures of the Organisers, Show Secretary & Show Manager must appear on this form and email addresses must be given. ** If the same person holds
two of these offices, the signature and details of another responsible Organising Member must be obtained. Acceptance of this transaction will only be approved if at least
two (2) of the people signing as show organisers are members of KUSA in good standing.
SHOW ORGANISERS – 2 SIGNATURES required. APPLICANT CLUB – 1 SIGNATURE- required
SHOW MANAGER – NAME/ SIGNATURE
EMAIL ADDRESS:
KUSA MEMBER NO.:
TEL. NO.
MOBILE:
SHOW SECRETARY – NAME/ SIGNATURE
EMAIL ADDRESS:
KUSA MEMBER NO.:
TEL. NO:
MOBILE:
** ORGANISING MEMBER – NAME/ SIGNATURE
EMAIL ADDRESS:
KUSA MEMBER NO.:
TEL NO:
MOBILE:
Applicant Club (licence lending Club) Chairman/Secretary – NAME/ SIGNATURE
Applications for Championship/Qualifying or FCI Show licences must be submitted six (6) months before the Show date. All Championship/Qualifying and FCI Licence
applications must be submitted direct to KUSA.
v.01.04.17