2015 VENDOR/RESCUE REGISTRATION
2015 VENDOR/RESCUE REGISTRATION BAR THE P K IN ARK APRIL A RK B ARK 2015 IN T HE P Please return completed form by APRIL 1, 2015 to: Omaha Dog Park Advocates c/o Mint Design Group 5916 Maple Street Omaha, NE 68104 SAVE THE DATE: Packet pick up will be held at the regularly scheduled DOG PARK ADVOCATES MEETING on Wednesday, April 8, 2015 / 5:33PM at the Swanson Library located at 90th and Dodge Streets. At the meeting, you will be given your rescue/vendor packet. If you are unable to attend, please contact: [email protected] COMPANY AND CONTACT INFORMATION Company Name: Contact Name: Phone: Address: Email: City, State, Zip: Web Address: COST AND REQUIRED INFORMATION TYPE OF ORGANIZATION (Please Check One) I am a Vendor/Business • Includes 4 wristbands for staffing • ODPA will provide one 8' table and two chairs • Organization must provide tent and any additional tables and chairs • Each company must be registered on separate forms One business/vendor per booth Will You Be Selling In Your Booth? (Please Check One) YES NO Registration: $150.00* *Non-refundable. Make check payable to Omaha Dog Park Advocates (ODPA) I am a Rescue Group Cost $50.00* • Includes 4 wristbands for staffing • ODPA will provide one 8' table and two chairs • Organization must provide tent and any additional tables and chairs One rescue group per booth *Non-refundable. Make check payable to : Omaha Dog Park Advocates (ODPA) Additional wristbands available the day of the event $10 each. Total amount enclosed $ In consideration for ______________________________ (rescue/vendor/company name) being accepted by Omaha Dog Park Advocates for participation in the 2015 Spring Bark in the Park. I (we) hereby release, forever discharge and agree to hold harmless Omaha Dog Park Advocates and the City of Omaha, their directors, employees and agents from all claims or liabilities of any kind relating to my (our) participation in this event even though that liability may arise out of negligence or carelessness on the part of the persons named in this waiver. Furthermore, I (we) hereby assume all risk of personal injury, sickness, death, damage and expense to this participant as a result of participation in said event. The undersigned further hereby agrees to hold harmless and indemnify said organization, its directors, employees and agents, for any liability sustained by said organization as the result of the negligent, willful or intentional acts of said participant, including expenses incurred attendant thereto. Authorized Signature: _________________________________________________________________________________________________ Date: _______________________________ By completing this registration, I understand and agree with the understanding that participation in dog park activities is not without risk to me or my dog(s). I hereby release the City of Omaha and it’s volunteers and agents, as well as the members of the Omaha Dog Park Advocates and it’s volunteers and agents from any and all responsibility or liability of any form, and for any and all damages sustained by myself, my dog or any member of my family, or any other person accompanying me to any event or function while on the grounds of the Omaha Dog Park located at approximately 11111 West Maple Road. I am responsible for any and all action by my dog(s), or harm caused by my dog(s), just as in any Omaha City Park. My dog(s) will be on leash at all times as required by the City of Omaha.
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