Primary Registrant/Contact

First Name *

Last Name *

Email *

Phone *

Age *

T-Shirt Size *

Participant Number 2

Participant 2 Gender *

Participant 2 T-Shirt Size *

Participant Number 3

Participant 3 Name *

Participant 3 Gender *

Participant 3 T-Shirt Size *

Participant Number 4

Participant 4 Age *

Participant Number 5

Participant 5 Age

Agreement *

ENTRANT RELEASE: Entry invalid if not signed. In consideration of the acceptance of this registration entry, I, the undersigned, assume full and complete responsibility for any injury or accident, which may occur during my participation in the event, or while I am on the premises of this event. I hereby release and hold harmless the sponsors, promoters, contributors and all other persons and entities associated with this event and their agents or employees from any and all injury or damage whether such injury or damage be caused by the negligence, the gross negligence, or misrepresentation of the sponsors, promoters, contributors, or any other person or entity associated directly or indirectly with the event or their agents or employees. I will not enter or participate unless medically able and properly trained. I assume the risk associated with this event, including but not limited to cold weather, and the conditions of the roads, all such risks being known and appreciated by me. Fees are non-refundable. I expressly assume the responsibility for any and all acts committed by my dog(s) that result in bodily injury or property damage. Further, I hereby grant full permission to any and all of the foregoing to use any photographs, videotapes, motion picture, recordings, or any other record of the event. I have read the foregoing and certify my agreement or my parent or guardian if under 18.

Signature (Parent or Guardian if under 18) *

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