French Bulldog Derby Race Registration Form 2021

CUDDLY presents The 3rd Annual Bulldog Derby: "Festival of Families" French Bulldog Derby Race Registration Form

(Bulldogs must be between 9 months to 6 years old to register)
Location: Boulder Station Hotel and Casino - 4111 Boulder Hwy, Las Vegas, NV 89121
Race Date: February 14th, 2021 / Valentine's Day / 02/14/2021
Time: 10:00AM - 7:00PM
Participant Information
Owner/Handler #1 *

First Name Last Name
INSTAGRAM Handle *
(preferably your bulldog's instagram account)
Owner/Handler #2: *

First Name Last Name
Phone Number *

Area Code Phone Number
Email *
example@example.com
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Emergency Contact Person *

First Name Last Name
Emergency Person Phone Number *

Area Code Phone Number
Relationship to Emergency Contact Person *
Bulldog's Full Name *

First Name Last Name
Age *
Date of Birth *

Month Day Year
Date
Gender
Please upload most recent picture of you bulldog *

Browse Files

Cancel of
Please upload a copy of your vaccinations/shots records *

Browse Files

Cancel of
Bulldog Derby Race Registration Fee is $50.00 (due immediately) PAID VIA PAYPAL (thebulldogrepublic@gmail.com)

non-refundable*
Terms/ Waiver/ Release
Please select below: *

I will follow the rules and regulations of the race event. I acknowledge that this race requires physical activity and there are possible risks and danger. I release the race event organizers or it's venue, partners, sponsors, vendors, or staff for any and all responsibility in case of any and all accidents, illnesses, or injuries. I allow taking my photos or the procedure images that can be used for the event portfolio or advertising. I confirm that all information in this registration form is accurate and true.
Participant's Signature *

Clear
Date Signed

Month Day Year
Date
Parent/Guardian Signature (If below 18 years old)

Clear
Date Signed

Month Day Year
Date
Should be Empty:

CUDDLY presents The 3rd Annual Bulldog Derby: "Festival of Families" French Bulldog Derby Race Registration Form

Participant Information

Bulldog Derby Race Registration Fee is $50.00 (due immediately) PAID VIA PAYPAL (thebulldogrepublic@gmail.com)

Terms/ Waiver/ Release