Official 2017 Registration Form

Owner’s Name_____________________________

Dog’s Name ______________________________Age __ Wt__ Check one: Standard_______   Mini_________

Address _________________________________

City _______________  State _____   Zip _______

Phone _______________________

Email _______________________

Event T-shirts: $10 each. T-Shirt Sizes (check all that apply) 2X and 3X sizes $2.00 extra.

__S  __M   __L  __XL  __2XL  __3XL    Total Quantity __

Where will you stay during your visit to Enid when participating in the Dachshund Dash:

__ Hotel  __RV  __ Friends & Family

Early Bird Registration Fee: $20.00. Due by Wednesday, October 4, 2017. Includes your dog’s photo and bio in the Official Dachshund Dash Program. Late Entry Fee: $45.  Make Checks Payable to Eagle Marketing.

WAIVER OF LIABILITY: In consideration of your accepting this entry, I the undersigned, intending to be legally bound, hereby, for myself, my heirs, executers and administrators, waive and release any and all rights and claims for damages I may have against Enid Paws 4 the Cause, Security National Bank, Chisholm Trail Expo Center, Eagle Marketing, their agents, successors and assigns for any reason and all injuries suffered by me or my dog in this event. Further, I hereby grant full permission to Eagle Marketing and/or agents authorized by them, to use any photographs, videotapes, motion pictures, recordings or other record of this event for any legitimate purpose.  I agree to abide by the rules and regulations of Enid Paws 4 the Cause.   Void where prohibited. For full contest rules call 580-242-1930 or send written request to Enid Paws 4 the Cause – 2005 W. Chestnut, Enid OK 73703. Email:lbenkendorf@eaglemkt.com

A copy of your dog’s vaccination records and photo are required when submitting registration form. Only one dog per entrant allowed.

Owner’s Signature _________________________Date__________

Entry Fee $_________   T-Shirt Fee $_________   Total Amt Paid $_____