Responsible Dog Ownership Day

SALISBURY MD KENNEL CLUB
CHARITABLE TRUST, INC.
Responsible Dog Ownership Day
SATURDAY, Sept 22, 2012

REGISTRATION 8A.M. TO 9:00 A.M. ~ WALK 9:00AM

SALISBURY MD KENNEL CLUB TRAINING CENTER
31663 WINTERPLACE PARKWAY, SALISBURY, MD

Protect our K-9’s
(Bullet & Stab Proof Dog Safety Vest)
For Area K-9 units and Small Animal
Oxygen Masks for the Fire Departments in the Tri County Area

DOG WALK REGISTRATION FORM

NAME______________________________________________

ADDRESS___________________________________________

PHONE #_________________ E-MAIL___________________

DOG & HANDLER $20.00 ~ ADDITIONAL DOGS $5.00 EACH

AMOUNT ENCLOSED_______________________________

Bring Day of Event

MAKE CHECKS PAYABLE TO SALISBURY MD KENNEL CLUB CHARITABLE TRUST
[Contributions are tax deductible IRS code 501(c)(3)]

In consideration of the furtherance of the Salisbury MD Kennel Charitable Trust, and of the Salisbury MD Kennel Club Charitable Trust permitting me and my dog(s) to participate in the SMKCCT Dog Walk, on behalf of myself, my heirs, executors, administrators and assigns, by submitting this form or participating in this event, I hereby waive and release any and all rights and claims for damages or injuries that I and my dog(s) might sustain while taking part in this event or as a result there of: the Salisbury MD Kennel Club Charitable Trust, Salisbury MD Kennel Club or any other person connected with the event. I give the Salisbury MD Kennel Club Charitable Trust and Salisbury MD Kennel Club permission to take photographs or video of myself and dog(s) at this event and use them on their websites, in print and in other media to promote the Salisbury MD Kennel Club Charitable Trust.

Signature
Date

For Questions Contact: mailto:gary9043@comcast.net