Special Events:   Dog Walk 2008 Registration


Registration is not final until the "Waiver of Liability" is marked as read and payment is received.

Event Waiver of Liability and Hold Harmless Agreement

In consideration of the acceptance of my/my dogs entry as a participant in the Dogs for the Deaf, Inc. Dog Walk event; I the undersigned, having full knowledge of the risks inherent in my participation, voluntarily agree to assume all risks incident to or arising from my participation in this event. I also agree not to litter and to exercise all safety precautions necessary to ensure the safety of myself, my pet, children and others.

I hereby waive and release myself, my heirs, assigns, executors and administrators, all event sponsors, City of Medford, Dogs for the Deaf, Inc. and its board of directors, employees and any agents from any and all claims, demands, actions, losses or causes of action for damages or injuries incurred, known or unknown, that I or my pet may have against them incident to, or arising from, my participation in this event. The undersigned also agrees to hold harmless and indemnify those mentioned above from any and all risks or damage caused by me or my pet. I further waive any and all claims, demands actions or causes of action for damage or injuries known or unknown that I (or my pet) may have against them, incident to or arising from my participation and to defend and hold them harmless from any of the above risks that may be caused by my self (or my pet). All dogs participating in the event will be screened at check-in. Any dog that is found to be aggressive, in heat, or that poses a threat to others in any way will be turned away. Dogs must be licensed, have current rabies and distemper vaccines. All dogs must be on a leash, able to walk or be carried the walk distance or in a stroller. I further give my permission to use any photographs, video-tapes, recordings or other record of this event for legitimate promotional purposes.

This form may also be printed out and mailed along with your check to:
Dogs for the Deaf, Inc.
10175 Wheeler Road
Central Point, OR 97502
OR Fax to: 541-826-6696

Registration includes: one T-shirt, one bandana, continental breakfast, hot dog lunch, contests, one raffle ticket and goodie bag per person. T-shirts may be picked up in advance at Grange Co-Op/Pet Country in Medford or Grange Co-Op in Grants Pass. Please call DFD for confirmed dates and times.
Participant Name *
Dogs Name(s) *
E-mail Address: *
Address *
City *
State *
Zip *
Phone *
I am registering as an individual - $20per person (walkers under the age of 18 must have a parent/guardians permission)
Parent/Guardian Name
I am registering as a team - $75 for 4, additional names may be added at $18 per person.
Team Name
Name of Captain (responsible for picking up T-shirts, collecting donations from team members and bringing to Dog Walk. Please call DFD for other arrangements.)
T-Shirt size(s) *
Team Members
Total registrations - individual *
Additional Team members - $18 per person
Total registrations - team *
Additional Bandanas - $3.00 each
Amount enclosed *
Visa, MC, AMX * Visa
Mastercard
American Express
Expiration Date *
Card number *
Name on card *
Click here to indicate you have read the Event Waiver of Liability and Hold Harmless Agreement *

* Required Email form by myContactForm.com



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Dogs for the Deaf
10175 Wheeler Road
Central Point, OR 97502
tel: 541-826-9220
fax: 541-826-6696
email: info@dogsforthedeaf.org