Registration text form

Dog Jog 2010 - Pre-Registration Form

Saturday, July 24 at East High - PREREGISTER BY JULY 21 and SAVE!

Instructions: Complete and return this form to FOP by July 21. MAIL EARLY!!! FORMS AND PAYMENT MUST BE RECEIVED at FOP by July 21. Forms with credit card payment may be faxed to (907) 334-6963. You can also register in person at Dog Tired Doggie Daycare, 310 E. Fireweed, Anchorage.

Fees for Pre-Registration ONLY: $20 Individual - $5 kids - $45 Family of Four - Dogs Walk Free!

Each person intending to walk (including friends and family members) must complete and sign a separate form. Forms may be photocopied. If you're under 18, make sure to have your parent or legal guardian sign for you. Please write legibly and don't forget to read the Rules of the Road!

Name:	Phone (day)	(eve)
Address:	City:	Zip:

5-k jog/walk or 1-mile stroll?	Bringing a dog?	Dog's Name(s):	Date of last rabies vaccination:
Is your dog adopted from FOP?

Rules and Regulations for Dog Jog 2010: For their own safety, no pets other than canines may participate. No bicycles, skateboards, roller blades or roller skates are allowed. Dogs must have ID and owners must be prepared to show proof of rabies vaccination. Dogs must be on leash AT ALL TIMES. No dogs in any stage of heat may participate. Dogs must be kept under control at all times; any unruly participant will be asked to leave. Water for dogs is served community-style; if your dog requires a separate drinking container, please bring your own bowl. Participants are expected to practice responsible pet ownership and clean up after your canine (scoopers provided). No children 12 or under are permitted to participate without an adult. No puppies under four months of age may attend.
Waiver of Responsibility: In consideration of your acceptance of this form, I hereby for myself, my administrators, my heirs and assigns waive and release all right and claims for damage I have against the organizer of this event, their associates and representatives. I also agree to obey all traffic laws, exercise all safety precautions, avoid littering and respect the property of others. I give full permission for use of my name and photograph in connection with this event. I have read and understand the rules and regulations for Dog Jog 2010.

Signature: __________________________
Note: Each participant must sign a waiver. A parent must sign for each child.

_____	*Enclosed is my registration fee*	$ _____________
_____	Enclosed is my donation on (DJ mascot) Harley's behalf	$ _____________
_____	Enclosed is an additional donation to help Friends of Pets	$ _____________
	*Total enclosed*	$ _____________