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

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

Parent / Guardian Signature

(required if less than 18 years of age)

Date

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.

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