Dog Walk 2017 Registration Form

13th Annual Pat McGee Memorial
Dog Walk
Saturday, June 17, 2017*
Registration: 9:15 – 10:15 a.m.
Point Gratiot, Dunkirk, New York
Walk begins at 10:30 a.m.
PRE-REGISTRATION BY MAIL IS STRONGLY SUGGESTED.
SAVE TIME AND BE REWARDED!
“FREE DOG” GIVEN TO EACH PRE-REGISTRANT
(a hot dog & drink, that is!)
GO TO EXPRESS CHECK-IN UPON ARRIVAL WHERE YOUR “GOODY BAG” WITH SHIRT WILL BE WAITING FOR YOU.
Registration donation is $18.00 and entitles each paid participant to a LHS “Goody” Bag and a 2017 Dog Walk
T-Shirt. Each participant must complete the following registration form and sign the waiver below it. For the
safety of all, a valid Rabies Certificate for each dog must be presented at registration. No exceptions can be
allowed (registration by mail requires a copy of rabies certificate to be attached). All dogs are required to have
an ID tag or microchip with the dog’s name and owner’s contact information on it. Rabies tag must also be
worn. Dogs must remain on leash at all times.
PLEASE PRINT ALL INFORMATION BELOW CLEARLY AND LEGIBLY.
DOG PARENT NAME____________________________________________________________________________
EMAIL__________________________________________________________________________________________
PHONE ___________________________________________(In case of rain, we will do our best to call you!)
RAIN DATE – SUNDAY, JUNE 18TH – Registration @11a.m. – 12:00 noon. Walk begins at 12:15 p.m.
CONTACT IN CASE OF EMERGENCY ____________________________________________________________
DOG NAME ________________________________________BREED_____________________________________
T-SHIRT SIZES - CIRCLE ONE SIZE ONLY.
S
M
L
XL
2XL
Waiver: I hereby waive and release all claims against the Lakeshore Humane Society, City of Dunkirk, event
sponsors and personnel for any injury I, my dog(s) and/or my guests might suffer in the event. Participants
under 18 will not be supervised during the walk and must have signature of parent or guardian to participate.
Signature________________________________________________________________________________________________
(Parent or Guardian if under 18)
This walk is to honor the late Senator Pat McGee who supported Buster’s Law. Buster’s Law was named
after an 18-month-old tabby cat that was doused with kerosene and burned to death by a Schenectady
teenager in 1997. Also known as the Felony Animal Cruelty Law, it created the category of “aggravated
cruelty to animals,” a felony offense punishable by up to two years in prison and a $5,000 fine.
SEND ALL COMPLETED, SIGNED REGISTRATIONS WITH PAYMENT TO: LAKESHORE HUMANE SOCIETY/DOG
WALK REGISTRATION, 431 E. CHESTNUT STREET, DUNKIRK, NY 14048. MAIL IN REGISTRATION ENDS ON
JUNE 7TH. Sorry, but no refunds are possible. Your registration is treated as a donation to the Lakeshore
Humane Society, a 501(c)(3) nonprofit organization.