Clone of Land of Oz IX

Handler's Name*

First NameLast Name

E-mail:*

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Your Quadruped DOG's name

Men's divisionWomen's divisionMen's Open (Expert)Women's Open (Expert)

You can register up to 6 dogs at a time with this form. Put in each dog's name and be sure to select all the games they will be playing in on Sunday. (If you need to register more dogs, put 6 on here and submit, and then complete an additional form) Open Freestyle or Sport $25 per team. Intermediate Freestyle or D/A $20 per team. Novice Freestyle and D/A is $15 per team.

Expert (Will be the Kansas State Champion)Intermediate (Intermediate overall champ)

Dog Number 1 Name

Dog Number 2 Name

Dog Number 3 Name

Dog Number 4 Name

Dog Number 5 Name

Dog Number 6 Name

My Products

Kansas State Champion$5.00

Add $5 if you want to be in the running for Expert or Intermediate Champion. (Combined points from Quad, Freestyle and D/A)

Quadruped $35.00

You can only play with one dog in the Quad

Open Freestyle$25.00

Open Expert, Microdog, Youth or Pairs

Quantity

Sport (Distance and Accuracy)$25.00

Expert or Microdog

Quantity

Intermediate Freestyle$20.00

Consists of one round of FS and one round of D/A

Quantity

Intermediate D/A$20.00

One round of D/A (What you know as Toss and Fetch) with a possible cut to top 15 for second round depending on turnout.

Quantity

Novice Freestyle$15.00

One round of Freestyle

Quantity

Novice D/A$15.00

(What you know as Toss and Fetch)

Quantity

Total $0.00

By Clicking Submit - you are digitally signing the standard waiver below.

RELEASE AND WAIVER OF LIABILITY

In consideration of my entry into any KCDD activities, I, the undersigned, intending to be legally bound, do hereby for myself, my heirs, executors, and administrators, waive and release any and all rights and claims for damages which I may have against the community or location where their activities are held; the Kansas City Disc Dogs (KCDD) board members and club members; their representatives; successors; employees; assignees and/or sponsors for any and all injuries or illnesses suffered by me or my dog (and I am also responsible for any damage(s) that my family, my dog(s), or I may cause on anyone or any contest property) as a result of my participation in KCDD’s said activities. I attest and verify that both myself and my dog are healthy and physically fit for these activities, and my dog is up to date on all vaccinations and registrations and I hereby assume the risk of any canine disease or injury which may be contracted at KCDD’s said activities. I understand and agree to accept the KCDD Code of Conduct. By my signature I also grant full permission to the KCDD and their assignees to use any photographs, videotapes, motion pictures, recordings or any record of these activities for any purpose whatsoever.

Land of Oz X