5k

5K9 Run and Whisker Walk Registration Form (please note we will need a separate registration form filled out for EACH participant)

Gender:

Shirt Size: (Check one)

Entry fees:

By April 21, 2017

After April 21, 2017

Whisker Walk

Please read the following waiver and if you agree, click the button below and submit it. When you do, you'll be taken to a confirmation page, which will include a link to PayPal, where you can then charge your entry fee by credit card.

I understand that by clicking the submit button, I am providing the electronic equivalent of my signature and I waive all claims for myself, my animal, my heirs and assigns against the Cumberland Valley Animal Shelter, sponsors, coordinating groups and any individual associated with the event and will hold them harmless for any and all injuries or illness which may result from my participation. I further state that I am in proper physical condition to participate in these races. I give my permission to the media to use my name and or photo in any newspaper, broadcast, telecast or any other account of this event, without limited obligation of anyone to compensate me thereof.

I will be responsible for the conduct of my dog, keeping him or her leashed at all times and cleaning up after my pet. I will not bring a
female dog in heat or a dog known to be aggressive toward people or other dogs. My dog is in proper physical condition to participate
in these walks and/or races.

I certify that my dog is up-to-date on vaccinations and has a current dog license.

I also give my permission for such first aid as is deemed necessary to be provided to me, my child or my pet on the premises or prior
to transport to a hospital for further treatment.

Access code:
Please enter MYCODE above.