PAWS IN THE PARK 2006

Registration Form

Pre-Registration Deadline: one week before the event

Name:____________________________________________________________

Address:________________________________________________________

City:______________________________________________________________

State:__________________ Zip:____________ Age (if under 18)_____

Phone: H______________________________________

W______________________________________

If attending as a member of a company, group or organization, please name:

________________________________________________________________________________

T-Shirt Size: ____M ___L ___XL ___XXL

Please list number ordered by the size above.

Extra shirts may be ordered for $10 each.

Number of dogs______

I am not currently a member, but enclosed is my membership fee of $15 plus my reduced entry fee of $18.
Check here ______

Check for updates on our website: http://dreampower-arf.com

PRE-REGISTRATION FEES

$18 /Dreampower Members, per person includes T-shirt, walker packet and participation in all events.

$20 /person includes T-shirt, walker packet and participation in all events.

$5/additional dog, includes walker packet and participation in all events.

DAY OF EVENT REGISTRATION:

$22/person * $20 DAR member * $8/additional dog

I cannot attend, but please accept my donation of $_______________ to help the animals. (Dreampower is a nonprofit, 501(c)3 organization. Donations are tax deductible to the extent allowable by law).

Total amount enclosed: $________________

Waiver/Release: In consideration of your acceptance of this form, I hereby, for myself, my dog, my administrators, my heirs and assign, waive and release any and all rights and claims for damages I have against the organizers for this walk, their associates and representatives or sponsors for injury or illness which may directly result from our participation. I also agree to obey all traffic laws, exercise all safety precautions, avoid littering and respect the property of others. I also give full permission for use of my name and photograph in connection with this event. I further state we are in proper physical condition to enter this event.

_______________________________________________________   _________________

Entrant’s signature Date

_______________________________________________________   __________________

Parent’s Signature (if entrant under 18) Date

Each participant must sign a form. You may copy this form.

Mail to:

Dreampower Animal Rescue

PO Box 62923

Colorado Springs, CO 80962-2923

Make checks payable to DAR. DO NOT send cash.

Food and drinks will be available at the park for an extra cost.