__ YES! I want to participate in the Dog Walk!
Enclosed is my:
$ ________ Individual or family walk fee
($5.00 per individual; $10.00 per family)
|
__ SORRY! I won't be able to participate, but I would
like to support the Dog Walk.
My donation of $_______ is enclosed.
This is a donation in ___ honor or ___ memory of:
_______________________________________
|
Your Name: __________________________________________________________________
Address: ____________________________________________________________________
City: _______________________________________________ State: ___ Zip: ____________
Home Phone: _________________________ Work Phone: ____________________________
How many dogs are you bringing? ______
___ YES! Non-returnable proof of rabies vaccination for each dog is enclosed.
YGRR Golden name(s) and #(s), if applicable:
______________________________________________________________ (for your name tag)
______________________________________________________________ (for your name tag)
______________________________________________________________ (for your name tag)
Names of additional family members. (Please include full names of everyone so we may prepare name tags in advance. Use additional sheets if needed.)
1. _____________________________________ 2. ____________________________________
3. _____________________________________ 4. ____________________________________
Please make checks payable to YGRR, Inc. and mail together with
registration form and non-returnable proof of rabies immunization for each
dog to:
Suzy Nattress, P.O. Box 173, Auburn, ME 04212
PRE-REGISTRATION FORMS AND PAYMENT MUST BE RECEIVED BY OCTOBER 8, 2000.
WALK-INS WELCOME, TOO!
Waiver of Liability:
I agree to absolve YGRR and all other individual or organization sponsors
of any blame or liability, misadventure, harm or inconvenience suffered in
any of the activities associated with the event. I will be responsible for
the conduct of my pet, for cleaning up after my pet and for keeping my pet
leashed at all times. I will additionally permit free use of our names and
pictures in broadcasts, newsletters, website or promotional materials.
Signature: __________________________________________
(Parent or guardian if less than 18 years old.)