City Pooch Festival Registration Form

City Pooch Festival Registration Form

POOCH FESTIVAL REGISTRATION

SATURDAY, SEPTEMBER 10 2016

10 am Registration 10:30 am Competition Begins

Florence Senior Center 7431 U.S. 42

DOG'S NAME
GENDER
ADDRESS
PHONE#
CITY
STATE
OWNER'S NAME
ZIP
       
cartoon_doggy_dog
NUMBER ASSIGNED 
BREED 
NUMBER OF TIMES DOG HAS PARTICIPATED IN THIS EVENT 
FEE PAID
CASH/CHECK#
MAKE CHECKS PAYABLE TO: City of Florence
8100 Ewing Blvd. Florence, KY 41042
(859) 647-5439
NRPA-logo
PARTICIPATING IN

REGISTRATION ACCEPTED DAY OF THE EVENT


CITY OF FLORENCE PARKS & RECREATION DEPARTMENT POOCH FESTIVAL WAIVER

Saturday, September 10, 2016

I/we participate in the City of Florence's Pooch Festival program at my/our own risk and recognize there are risks involved including injuries and will pay all medical expenses incurred and agree to indemnify and hold harmless the City of Florence, its elected officials, employees, the instructors, fellow participants and others affiliated with the program from any and all liabilities, claims, demands, actions or causes of actions resulting from physical injuries out of my/our participation. I have read and understand the nature of this waiver.

FILLER NAME
AGREEMENT DATE
Format: 05/12/2017
       
 

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