JUNIOR RACE ENTRY FORM
AMERICAN DOG DERBY
February 17th, 18th, 19th 2011
NAME____________________________AGE___ DATE______________
ADDRESS____________________________________________________
CITY______________________STATE________ZIP________________
HANDLER/GAURDIAN (NAME)________________________________
| Warren Brown Junior Race | 1 to 3 Dogs | Entry Fee:$20.00 |
I agree to be responsible for my conduct and that of my dogs. I will not hold the American Dog Derby, operating as a member of the Ambassador’s Cup Sports Foundation, it’s members, race sponsors, land owners (private, Federal Government, Idaho Department of Transportation, State of Idaho, Fremont County, Idaho), City of Ashton, or the race committee, employees or volunteers, individually or jointly responsible for damage to myself, handlers, dogs or equipment.
I also agree that I will not bring sick dogs to the race. If any of my dogs have been sick in the last 30 days, I will understand that they will not be allowed on the race trail or at the checkpoints and that my failure to comply may result in disqualification.
I also will process my dogs through the vet checks that are held prior to the race and will present proof of required vaccinations for my dogs. (The vet checks will begin Thursday at 2:00 p.m.)
Thank you for your cooperation.
MUSHER’S SIGNATURE________________________DATE_________
I also agree to the responsibility statement above and give the musher signing above my permission to participate in the American Dog Derby for ages 16 and under.
Parent/Guardian signature_________________________Date_________
Mail Entry Form To:
Karren Nygaard
3328 E 1100 N
Ashton, ID
83420
208-652-7980
thenygaards@fairpoint.com