ROWAYTON DOG PARK REGISTRATION

ROWAYTON DOG PARK REGISTRATION

Please fill out the form to register your dog(s) for the dog park in Rowayton. You will need to have your dog license information in front of you when you fill out this form. Applications filed on July 26th or later will be processed in September
Owner Information
Full Name

First NameLast Name
Owner Email Address
example@example.com
Phone Number
Please enter a valid phone number.
Address -

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Veterinarian Name

First NameLast Name
Veterinarian's Contact Information
Please enter a valid phone number.
Authorized User Information

You may add up to one authorized person who can also take your dog to the park
Full Name

First NameLast Name
Authorized user Email Address
example@example.com
Phone Number
Please enter a valid phone number.
Dog One Information

Please use the License Tag Number, Issue date and ID Number from the paper license you received from the town clerk. Do not use tag numbers from your veterinarian.
Dog's Name
Dog's Breed
Dog's Gender

MaleFemale
Dog License Tag Number *
Dog License Issue Date*

MonthDayYear
Date
Dog License ID Number *
What town issued the dog license? *
Rabies Certificate Expiration Date*

MonthDayYear
Date
Dog Two Information

If you have a second dog you would like to use the park, please fill out the information below. If you are only registering one dog, you can leave this part blank.
Dog Two's Name
Dog Two's Breed
Dog Two's Gender

MaleFemale
Dog Two License Tag Number
Dog Two License Issue Date

MonthDayYear
Date
Dog Two ID Number
What town issued the dog license?
Rabies Certificate Expiration Date

MonthDayYear
Date
Dog Three Information

If you have a second dog you would like to use the park, please fill out the information below. If you are only registering one dog, you can leave this part blank.
Dog Three's Name
Dog Three's Breed
Dog Threes's Gender

MaleFemale
Dog Three License Tag Number
Dog Three License Issue Date

MonthDayYear
Date
Dog Three License ID Number
What town issued the dog license?
Rabies Certificate Expiration Date

MonthDayYear
Date
Rowayton Dog Park Membership Rules and Regulations: Check each box to confirm you have read the rules.*

All dogs must be spayed/neuteredNo sharing of Lanyards and access passes. Violations will lead to suspension. Lanyards must be displayed at all timesOwners must stay inside fenced area and limit cell phone usageClean up after dogs and dispose of waste bags in the receptacles.Stop dogs from digging and fill any holes dug by dogsNo children under 5 in the parkNo food, treats, alcohol, smoking, or glass containers allowed.Park hours are from 7:00 AM to 8:00 PM, no one is allowed in the park when it's darkDogs must wear current rabies and town license tagsNo pronged or choke collars and leashes should be removed before entering the parkAggressive dogs must be leashed and removed immediatelyOnly 3 dogs allowed per owner/authorized userI understand that if I falsify any of the information on this form, I could be permanently banned from the park.I understand that the Sixth Taxing District may request a photo of my license if the information on the form cannot be verified.
By signing, you acknowledge that you have read, understand, and agree to follow all rules and regulations of the Rowayton Dog Park. Violation of these rules may result in loss of membership without a refund. You assume full responsibility for ensuring that all authorized users understand and comply with these rules, whether or not you are present. *

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My Products - CHECK ALL BOXES THAT APPLY

Rowayton or Norwalk Resident Permit

$30.00 Quantity

Non-Resident Permit

$50.00 Quantity

Second Dog

$15.00 Quantity

Third Dog

$15.00 Quantity

Total

$0.00

Credit Card

Should be Empty:

ROWAYTON DOG PARK REGISTRATION

Owner Information

Authorized User Information

Dog One Information

Dog Two Information

Dog Three Information

Credit Card