PAWS WALKING IN THE PARK
Registration &
Release Form
Please print out and complete this form to sign up for Paws Walking in the Park.
Please bring this form along with your Pledge Sheet to the Park on the day of the event. (It prints best if you select just
the forms and print in 'landscape' format.)
Sunday,
June 13th, 12:30 – 2:00 p.m.
Schuster Park, Neillsville
Walker’s
Name________________________________________ Phone______________
Address_______________________________ City________________ State______ Zip_______
Will you have a pet joining you on the walk? Yes
No
If so, Pet’s Name:____________________ Rabies
Tag #______ CCHS alumni? Yes
No
Walker’s T-Shirt Size: S M
L XL XXL XXXL
I am unable to walk, but here is my donation in support of this special cause.
Waiver: In consideration of my signing this agreement, I hereby for myself, my heirs and administrators assume
any and all risks which may be associated with this event. I waive and release any and all rights for damage
which I may have against the organizers, Clark County Humane Society, Inc., and any others connected with this event, their
representatives, succesors and assigns for any and all injuries or damages of any kind whatsoever suffered by me or my pet
as a result of taking part in this event and any related activities. My pet has all current vaccinations
as required by law. I consent to the use of my photograph or likeness from this event for any publicity.
________________________________________ _____________
Participant Signature
Date
___________________________________________________
_________________
If under 18,
Parent or Guardian Signature
Date
PLEASE DETACH
AND SUBMIT ABOVE REGISTRATION FORM
WALK INFORMATION
§
All participants must
register and sign the release.
§ You may walk with or without a pet.
§
Each participant is responsible,
and expected, to clean up after their pet. Bags will be provided at registration.
§
For information, call
743-3283.
§ Participants with $25 or more in pledges will receive a t-shirt. Please indicate
your size above.
§ All registration forms and pledges must be turned in at the event.
Checks must be made payable to CCHS.
§ Walkers under the age of 12 must be accompanied by an adult.
§
All dogs must be leashed,
licensed, and under owner’s control at all times. Pets must not be aggressive to others or they will
not be allowed to participate. Proof of current vaccinations must be provided.
§
No female dogs in season
allowed.
§
Walk will take place
rain or shine.
§ This event is non-competitive.
§
First through third place
prizes will be awarded based on pledges received. Other prizes will be awarded by random drawing of all walkers.
§
Water will be available
for walkers and pets. Pet water will be served community style. If you prefer, you may
bring your own pet’s bowl.
