2016 Ohio State Fair and Wayne County Fair Dog Project Identification Form and Vaccination Certificate

This form is Due for Ohio State Fair - July 1, 2016 and Wayne County Fair August 1, 2016 Identification Form

(To be completed by Exhibitor)

Exhibitors: Complete this identification form. Exhibitors, parents/guardians must read the statement at the bottom of this section and sign to verify reading the 2016 Wayne County Dog Project Requirements (and 2016 Ohio State Fair Dog Show Rules/Show Venue Rules, if applicable) and agree to abide by them, and have a Permission to Participate form on file in the county Extension office.

Exhibitor’s Name County a 4-H Member In Phone ( ) Mailing Address City State Zip Dog’s Call Name Dog’s Birth Date Age Mo./Day/Yr. Predominant Breed Color & Markings Sex: [ ] Male [ ] Neutered Male [ ] Female [ ] Spayed Female Dog License Tag No. (Must list tag number)

Signatures Required: We verify we have read the 2016 Wayne County Dog Project Requirements, and if showing at the OSF, the 2016 Ohio State Fair Jr. Fair Dog Show/Show Venue Rules, and agree to abide by these rules. We have a signed Permission to Participate in Ohio 4-H Dog Activities Disclosure and Release of Claims form on file in our county Extension office.

Exhibitor’s Signature Parent/Guardian Signature Date Signed

Vaccination Certificate (To be completed by Veterinarian)

Exhibitors: Take this form to your veterinarian. This Vaccination Certificate must be completed and signed by a licensed, accredited veterinarian. All dogs MUST have current rabies vaccinations. Your veterinarian must document on this form whether your dog’s Rabies vaccination is current for 1 year or 3 years by filling in the “Date Expires” blank. Additionally, the Ohio 4-H Dog Program requires all dogs be vaccinated yearly for Distemper, Hepatitis, Leptospirosis, Parainfluenza, and Parvovirus for exhibition at County and State Fair Dog Shows, unless otherwise noted below by veterinarian. Bordetella vaccination is recommended, but not required. Veterinarian protocol for vaccinations will be followed. A licensed, accredited veterinarian must administer all vaccinations. All vaccinations must be current through September 15, 2016 for county judging and current through August 4, 2016 for showing in the Ohio State Fair Dog Show.

Rabies Date Given Date Expires Product Serial # DHLPP Date Given Date Expires Product Serial #

With the exception of Rabies, specific vaccination requirements may be waived if the veterinarian initials the applicable box below. [ ] Does not give Leptospirosis vac. [ ] Other, please list [ ] Does not give yearly core vac. [ ] Titer Testing (attach proof)

Clinic Information

Clinic Name

Mailing Address

City State Zip

Print Administering Vet’s Name

Veterinarian’s Signature

Date Clinic Phone ( )

OwnershipRequirements1. DogsparticipatinginallWayneCountyFairJuniorFairDogShowactivities

musteitherbeownedbythejuniorfairexhibitorortheexhibitor'simmediatefamily.(Exception:AssistanceDogs)Theymustbeinthecontinualcareofthejuniorfairexhibitorforthedurationoftheproject.ThedateofownershipmustbenolaterthanJune1,2016.Proofofownershipistheburdenoftheexhibitorandexhibitor'sfamily.

Definitionsa. Immediatefamilyisdefinedasthejuniorfairexhibitor’sfather,mother,

brother,sister,uncle,aunt,grandfatherorgrandmother,includingthecorrespondingstepandhalfrelations,orbyamemberoftheexhibitor’shousehold.

b. Continualcareisdefinedasthejuniorfairexhibitorbeingresponsibleforandinvolvedinthefeeding,cleaning,andcaringoftheproject.

c. Ownership–Registereddogs:Theexhibitor’sname,oramemberofhis/herimmediatefamily’sname,mustappearontheregistrationcertificateofadogregisteredbyAKC,UKC,individualbreedregistries,herdingdogregistries,etc.Co-ownershipofadogispermittedprovidedtheexhibitor’sname,oramemberofhis/herimmediatefamily’sname,islistedontheregistrationcertificate.

d. Ownership–Non-registeredpurchaseddogs:Anon-registereddogpurchasedfromaprivateowner,petshop,humanesociety,dogrescue,etc.,musthavetheexhibitor’snameoramemberofhis/herimmediatefamily’sname,onthebillofsale.

e. Ownership–Dogsfound/gifts:Ifadogwasgiventotheexhibitororimmediatefamily,orfoundbytheexhibitororimmediatefamily,theexhibitororamemberofhis/herimmediatefamilyreceivingorfindingthedog,shouldverifythedatereceivedorfoundbyuseofveterinaryrecords,doglicenses,andotherformsofrecords,andwriteastatementastothedefiniteorapproximatedatethedogwasreceivedasagiftorfound.ItisrecommendedthatacopyofthisstatementbeonfileinthecountyExtensionoffice.

2.LeasingadogisnotpermittedforWayneCountyFairandtheOhioState Fairdogshowparticipation.LicenseRequirements:Alldogsmustbecurrentlylicensedintheexhibitor’scountyofresidence.Theexhibitormustturninacopyofthecertificateoflicensewiththisform.Thedoglicensetagaloneisnotsufficient.ThishealthformandacopyofthedoglicenseareduetotheWayneCountyExtensionOfficebyAugust1,2016.

IfyouplantoshowattheStateFair–thevaccinationformisthesameandyoumusthaveaVeterinarianfilloutthatform.ForStateFairRulesandHealthRequirementsgotothefollowingwebsiteand

thenscrolldowntotheStateFairsection.http://www.ohio4h.org/statewide-programs/animal-

sciences/dog/dog-resources

HealthRequirements1. TheOhioDepartmentofAgriculturerequiresdogstohavecurrentRabies

vaccinations.Pleasehaveyourveterinariandocumentonthisformwhetheryourdog’sRabiesvaccinationiscurrentfor1yearor3yearsbyfillinginthe“DateExpires”blank.Additionally,theOhio4-HDogProgramrequiresthatalldogsbevaccinatedyearlyforDistemper,Hepatitis,Leptospirosis,Parainfluenza,andParvovirusforexhibitionattheWayneCountyandOhioStateFairDogShow.However,ifyourveterinarianfeelsthatadministeringtheLeptospirosisvaccinationwouldjeopardizeyourdog’shealth,itmaybewaived,andtheadministeringveterinarianmustinitialtheapplicableboxundertheDHLPPsection.Ifyourveterinariandoesnotgiveyearlycorevaccinesorvaccineantibodytitertests,theadministeringveterinarianmustinitialtheapplicableboxundertheDHLPPsection.

2.Allvaccinationsmustbeadministeredbyalicensed,accreditedveterinarian.FortheWayneCountyFairDogShow,allvaccinationsmustbecurrentthroughSeptember15,2016.

3. Othercertificatesofvaccination,computerizedvaccinationrecords,petrecordcards,orkennelrecordswillnotbeaccepted.Itistheexhibitor'sresponsibilitytomakesurethatallhealthrequirementsforCountyFairaremet.

4. Anydogsexhibitingabnormalitiesorsymptomsofsickness,disease,orparasiteinfestationasdeterminedbythedogshowofficialswillbeeliminatedfromtheshowandmustberemovedfromtheFairgrounds.Ifadogisunderveterinarycareforahealthconditionthatisnotinfectiousorcontagious,theexhibitormustbringahealthcertificatefromtheattendingveterinarianverifyingtheconditionandtreatment.Decisionofthedogshowofficialsisfinal.

5. BitchesshowingsignsofheatarenotpermittedtobeshownandarenotpermittedontheFairgrounds.Ifabitchshowsanysignsofheat,shewillbeeliminatedfromtheshowandmustberemovedfromtheFairgrounds.Anybitch,whichappearssoattractivetomalesastobeadisturbingelement,willbeeliminatedfromtheshowandmustberemovedfromtheFairgrounds.Decisionofthedogshowofficialsisfinal.(Note:Checkwithyourveterinarianseveralmonthspriortotheshowifyouthinkyourdogisduetobeinheatduringtheshow.He/shemaybeabletomedicateyourdogtodelayestrus.)

6. Pregnantand/orlactating(nursing)bitchesarenotpermittedtobeshownandarenotpermittedontheFairgrounds.

MakesureyourveterinarianfillsinALLoftheblanks!Besureyourveterinarianprintshis/hernameonthelinelabeled“AdministeringVeterinarian’sName”andsignshis/hernameonthelinetitled

“Veterinarian’sSignature.”Besurehe/shefillsinthedateandclinicphoneatthebottomofthecertificate.

ThisformisadaptedfromtheMinnesota4-HDogProjectIdentificationFormandVaccinationCertificate.L.Miller,ExtensionSpecialist,4-HYouthDevelopment.01/01/05