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Paw
Festival - Paws on Parade
2011 Pledge Collection Form |
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| Walker's Full Name: ________________________________________________ | |
| Address: ______________________________ | City: _____________ State: _____ Zip: _______ |
| Phone: _________________T-Shirt size:_____ | Email: __________________________________ |
| Sponsor's Name (Please Print) | Street Address | City | Zip | Phone # | Amt Pledged | Paid |
| eg: Ima Petlover | 123 Wag Way | Swansea | 62226 | 618-111-2222 | $25.00 | X |
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Total you collected:
$_______________
Total Number of Pages (Attach additional sheets for more pledges). Page _____ of _____. Please make checks payable to "BARK." Sending cash in the mail is not recommended. Please submit a check to BARK Rescue in the amount of the cash donations you receive. For more information, email us at barkemail@yahoogroups.com, or visit www.pawfestival.com. I, hereby for myself, heirs, executors and administrators, release and forever discharge Belleville Area Rescue of K-9's (BARK), its members, sponsors, agents, representatives, volunteers, successors, and assignees and any other bodies, corporations, firsts, associations, municipalities, or persons from any claim for damages resulting in injury either to myself, my dog, or my family during BARK’s 2011 Paw Festival-Paws on Parade on June 11, 2011. I also give full permission for the use of my name and photograph in connection with this event. In compliance with the rules, I confirm that my dog has received current distemper/parvo/rabies vaccination. I certify that I am at least 16 years of age, and that if I am under the age of 18, the signature of a parent or guardian is included. Persons under 16 years of age should be accompanied by a parent or guardian. Walkers Signature:____________________________________________ Date:_______________________
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