1 Mile Walk/5K Run Preregistration

First and Last Name:*
Address:*
City:*
State:*
Zip:*
Phone Number:*
Email Address:*
Age (must be completed and submitted by parent or guardian if under 18 years old):*
Pet Name:
Gender:
1 Mile Walk or 5K Run:*
Shirt Type:
Shirt Size: *

Preregistration is not required for this event but is strongly encouraged. Please bring your donation form and your pets current rabies vaccination certificate to check in on Saturday, May 19, 2018. If you are unable to attend the walk you can still drop off pledges at the shelter to help the animals.

To be eligible for a shirt, the participant must have a minimum of $50 in pledges*
The first 50 participants who raise $75 or more in pledges will receive a free gift bag.

*While supplies last

By submitting this form I acknowledge that participating in the Cause for Paws walk/run is a potentially hazardous activity and I assume all risks associated with this event. Having read this waiver and knowing these facts and in consideration of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release the Humane Society of Wicomico County, its officers, employees, all event sponsors, vendors, volunteers and their representatives and successors from all claims or liabilities of any kind arising out of my 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. I grant permission to all of the foregoing to use my photographs, motion pictures, recordings or any other record of this event for any legitimate purpose.

Signature:*
Parent or Guardian Signature if under 18 years:
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