Registration Fees:
* REGISTER EARLY to guarantee your t-shirt
is available on race day!!
$20.00 Adult (age 16 & up), 5k or 1 mile, with or without dog, if received by May 28th ($25.00 after May 28)
$15.00 Children (age 15 & under) - 5K or 1 Mile
walk, with or without dog) , if received by May 28th
($20.00 after May 28)
$45.00 Family (Parent(s) & Children with 2 t-shirts
included)
$10.00 for adult or $5.00 child with no t-shirt
I cannot participate, but please accept this donation
of: $__________.
All donations go directly to help provide food & vet
care for the cats & dogs at PAWS, a 501(c)(3) charity.
PLEASE MAKE CHECKS PAYABLE TO:
"PAWS Humane Society"
4th Annual
Cedar Dog Jog
date!
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2015
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Saturday, June 6, 2015
PO Box 651
Charles City, IA 50616
___________________________________ ______________
Signature (Parent/Guardian if under 18)
Date
PAWS Humane Society
PAWS Humane Society
Waiver and Release: In consideration of my being permitted to
participate in "The Cedar Dog Jog " on June 6, 2015, the sufficiency of which I acknowledge, I, the undersigned, intending to
be legally bound hereby for myself, my heirs, assigns, executors
and administrators, do hereby waive and release any and all
rights, claims, demands, or causes of action of any nature I may
have against PAWS Humane Society, City of Charles City,
and/or their directors, employees, agents, officials, volunteers,
sponsors or any other representatives for any and all injuries or
other damages of any kind that may be suffered by me or my
dog in this event, from the date of this event forward. I hereby
certify that my dog and I are physically fit and have sufficiently trained for the competition of this event. I acknowledge that
any injuries sustained by me or my dog during the course of this
event may be caused by or arise out of risks inherent to a crosscountry race, of which I have full knowledge and which I
assume. I will be responsible for the conduct of my pet, for
cleaning up after my pet and for keeping my pet leashed at all
times. I agree to indemnify and hold all sponsors of this event
harmless against any and all claims, demands, or causes of
action of any kind for any accident, injury or damage whatsoever caused to any person or property by me or my dog arising,
directly or indirectly, prior to, during, or after the course of this
event. I will additionally permit the free use of our names, pictures or likeness in broadcasts, or promotional materials.
I understand the terms of this Waiver and Release and by my
signature below affirm that I am signing this waiver and release
freely and voluntarily.
Start at 8:30 AM
5k or 1-Mile Fun Run/Walk
WITH OR WITHOUT YOUR DOG
ALONG THE SCENIC
RIVERFRONT PARK
CHARLES CITY, IOWA
#
Dog Jog Rules
To keep everyone safe, special rules apply for those running/walking
with a dog:
• Limit 1 dog that is at least 6 months old, per adult.
• All dogs must wear ID and/or rabies tag.
• Dogs must be on a 6-foot leash at all times (No flex leashes)
• Bring only dogs that socialize well with other dogs & people.
(PAWS has the right to refuse entry or remove a dog from the course if
it is a threat to people and/or other dogs.)
• Female dogs in any stage of heat are prohibited.
• Please be kind to your four-legged companion and maintain
a leisurely pace.
• This is a fun event - not a timed or competitive race.
• Owners must clean-up after their dogs before, during and after the
event. Plastic baggies will be provided.
Registration/Check-In
• At the labyrinth at Riverfront Park in Charles City. (Going East on
Clark Street, turn right on Hawkins Street and go to the end of the street.)
• Detailed map available on the day of the event. Available in advance by
visiting our Facebook page.
ENTRY FORM
Check-in/Registration: 7:30 - 8:15 AM
Jog/Walk starts at 8:30 AM
* Please note: One signed form is required
for each participant or family. Please
complete this entry form on both sides, cut,
and return it with the entry fee and/or
donation to:
PAWS Humane Society
P.O. Box 651
Charles City, IA 50616
*Pre-registration forms must be received
by May 28. 2015!
Name:_________________________________
Address:_______________________________
City: _______________ State:___ Zip:_______
Phone: (
)____________________
E-mail address: _________________________
Gender: M
F
If under 18, age:_________
EVENT PARTICIPATING IN:
5K Run/Walk _____
1 Mile Run/Walk_____
T-SHIRT INFORMATION:
Circle T-shirt size: Adult: S
M L XL 2XL 3XL
(100% cotton - $2.00 more for 2XL and 3XL)
Youth: XS S
M
L
• All pre-registered dogs will receive a colorful bandanna and treats.
Extra t-shirts: $12.00 each - Size __________
• Parking is available at the I.C. Ball Fields just off of Clark Street
Quantity __________
For Dog Entrants Only:
(before Hawkins Street).
Canine Name: ____________ Weight ______lbs
Have a question?
E-mail: [email protected] or call 641-228-0441
Registration forms and map are available to print online at:
www.pawsonline.org or on our Facebook page.
Breed:___________ Age: ________ Sex: M
Adopted from PAWS? Y
F
N
Vet Name: _______________ Ph: ___________
Rabies ID#_____________ Exp. Date: ________
(ONLY 1 DOG PER ADULT!)