3rd ANNUAL DOG WALK

SALISBURY MD KENNEL CLUB
CHARITABLE TRUST, INC.
3rd ANNUAL DOG WALK
SATURDAY, APRIL 6, 2013
REGISTRATION 8: 00 A.M. TO 9:30 A.M. '" WALK 9:30 A.M.

SALISBURY MD KENNEL CLUB TRAINING CENTER

31663 WINTERPLACE PARKWAY, SALISBURY, MD

BENEFIT VESTS FOR OUR
POLICE K9'S IN THE TRI COUNTY AREA
(Bullet & Stab Proof Dog Safety Vest)

& OXYGEN MASKS FOR SMALL ANIMALS
FOR FIRE DEPTS IN THE TRI-COUNTY AREA
Canine Good Citizen Test to Follow $10.00

DOG WALK REGISTRATION FORM

NAME

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ADDRESS

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PHONE # _______________________ E-MAIL __________________________ _

DOG & HANDLER $20.00 ""-J ADDITIONAL DOGS $5.00 EACH
AMOUNT ENCLOSED

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Bring Day of Event or Mail by 3/20/13 to' Bonnie Garris, 321 Cedar Dr., Salisbury, MD 21804
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.