Vollmer Farm - Run Registration Form

Great Pumpkin
Inaugural 5K/1 Mile Dog Run
October 25, 2008

Complete the information below and click on the submit button. Please note that any information or addresses provided will not be distributed elsewhere.

First Name:
Last Name:
Age: *As of October 25, 2008
Gender:	Male Female
Address:
City:	State: Zip:
Daytime Phone:
Your Email Address: * this info will not be shared with others
Dog's Name:
Dog's Breed:
Dog's Age: *As of October 25, 2008
T-Shirt Size:

Provide any other information/comments you would like us to know:

By checking this box, I agree as follows:

Rules of the Dog Run
Dogs should be at least one (1) year old to run. If younger please use discretion and walk, jog, or carry your loving companion. Only one dog and one human will be officially timed per Registered Bib Number.

1. Dog & Partner must be tethered to each other. For an official finish time the tether must be the same length at the START and at the time of crossing the finish line. Variable lengths are acceptable during the run.
2. Time is calculated when DOG's nose crosses finish line.
3. Partner is responsible for cleaning up dog sculptures. (doo doo)

Disclaimer: As the owner and/or partner of registering dog I know that participating in Great Pumpkin 5K/1 mile Dog Race hereafter called The Event is an inherently dangerous activity. I agree not to enter and participate unless I and my dog are medically able. I agree to abide by any decision of a race official relative to my ability to safely complete The Event. I am voluntarily entering and knowingly assume all risks associated with participating in The Event, including, but not limited to, falls, spills, contact with vehicles, other participants, spectators or others, the effect of weather, including high heat, extreme cold and/or humidity, all such risks being known and appreciated by me.
Having read this waiver and knowing these facts, and in consideration of your accepting my registration, I, for myself, and anyone entitled to act on my behalf, waive and release 3 Punkins, INC DBA Vollmer Farm and their agents or officers, all Sponsors of the Event and each of the respective representatives and successors, officers, directors, members, agents, and employees of the foregoing, from all present and future claims or liabilities of any kind, known or unknown, arising out of my participation in The Event even though that liability may arise out of ordinary negligence or fault on the part of the persons named in this Waiver.
I grant my permission to all of the foregoing to use or authorize others to use photographs, motion pictures, recordings, or any other record of my participation in the Event for any legitimate purpose without remuneration.