Dog Walk Registration Form

Dog Walk Registration Form
Walker First & Last Name

First NameLast Name
Walker's Age

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Configurable list
Vet/Clinic Name
Vet/Clinic Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Walk Participant Waiver (please read and sign below)
- I waive and release all rights and claim for damage against the organization or anyone else associated with CVAS's Dog Walk and Contests, for any injuries suffered by me or my dog as a result of taking part in the day's activities
- I will be responsible for the conduct of my dog, keeping them 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
- I certify that my dog is up to date on vaccinations and has a current dog license
Name

First NameLast Name
Should be Empty: