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4-H PET SHOW ENTRY
THE MONTGOMERY COUNTY AGRICULTURAL FAIR Office Use Only
16 CHESTNUT STREET, GAITHERSBURG, MD 20877 Received: _______________

Name: _______________________________________________ Exhibitor #: ____________________ Tally: ___________________

Address: ___________________________________________________________________________ Letter: __________________

City: _____________________________________ State: _____________ Zipcode: ________________ Comp.:__________________

4-H Age: _________ (as of January 1) DOB: ______________ Phone: _____________________________
Passes: __________________
E-mail: _____________________________________________________________________________
Absolutely NO entries
I have read, understand and agree to abide by all the rules and regulations published in the Montgom-
ery County Agricultural Fair Premium Catalog. I also agree that I will not hold the Montgomery County will be accepted after
Agricultural Fair liable for any accidents or injury, which may occur while participating in the Fair. July 20, 2018.
I have read the rules and expectations for participation in the MCAC fair and promise to support and Use certified mail and
practice humane treatment of animals at all times.
print a receipt if using
Exhibitor’s Signature: _____________________________________________ Date: ________________ online entry.

Parent/Guardian Signature: ______________________________________ Date:__________________
Rabies Vaccination
NOTE: USE ONE ENTRY FORM PER EXHIBITOR, ONE PER ANIMAL THAT HAS A RABIES VACCINA-
TION, AND ONE LINE PER CLASS. Number: ___________
Name of Animal: _________________________________________ Exp Date: ___________
Health Certificate date: ____________________________________ Current Health Records:
(certificate must be attached)
Vet’s Name: _____________________________________________ Rabies Information must be
shown the day of show.

ALL ENTRIES ARE FOR DEPARTMENT 16 ONLY—one form per exhibitor

Division Class Name of Animal and Class Description

4-H Family Discount Pass (includes parking): Rates/Prices Subject to Change—$10/day; $50/season
mcagfair.com
ENTRY DEADLINE IS JULY 20th