Doggie Dash Registration

Name
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Dog's Breed
Dog's Name
Dog's Color
Describe Special Markings &/or Costume
Please Check Your Preferred T-Shirt Size Below
- Small
- Medium
- Large
- XL
- XXL
WAIVER & RELEASE OF LIABILITY
(You must sign this form to participate in event.)
I hereby waive all claims against AAHS, sponsors or personnel for any injury I might suffer in this event. I attest that I am physically capable & prepared for this event (& any dog that participates with me in this event is in good physical condition & able to complete the course without injury to itself or others). All dogs in this event must have a current rabies vaccination & be under the control of the owner at all times. I grant full permission for organizers to use photo-graphs of me and quotations from me in legitimate accounts and promotions of this event.
Signature*
Date
Date Format: MM slash DD slash YYYY
Parent / Guardian Signature
(required if less than 18 years of age)
Date
Date Format: MM slash DD slash YYYY
Early registration through 9/18
Price: $10.00
after 9/18, register at the event for $15
Name
This field is for validation purposes and should be left unchanged.