Online Registration

Your Name*

Your Email*

Which Event Will You be Participating In?*

5K Fun Run
1 Mile Walk

Your Age (on race day)

Your Sex*

Female
Male

Your T-shirt size*

Will your Dog be Participating in The Humane Race?*

Yes
No

Waiver & Release*

I accept the Waiver & Release

Please read and indicate your agreement by checking the check box above.

In consideration of my being permitted to participate in "The Humane Race" on May 8, 2010, the sufficiency of which I acknowledge, I, the undersigned, intending to be legally bound hereby for myself, my heirs, assigns, executors and administrators, do hereby waive and release any and all rights, claims, demands, or causes of action of any nature I may have against The Berkshire Humane Society, Town of Williamstown, Williams College, and/or their directors, employees, agents, officials, volunteers, sponsors or any other representatives for any and all injuries or other damages of any kind that may be suffered by me or my dog in this event, from the date of this event forward.

I hereby certify that my dog and I are physically fit and have sufficiently trained for the competition of this event. I acknowledge that any injuries sustained by me or my dog during the course of this event may be caused by or arise out of risks inherent to a cross-country race, of which I have full knowledge and which I assume.

I further certify that all information and or documentation that I provided in connection with this application is true and accurate as of the date of the scheduled event.

I will be responsible for the conduct of my pet, for cleaning up after my pet and for keeping my pet leashed at all times.

I agree to indemnify and hold all sponsors of this event harmless against any and all claims, demands, or causes of action of any kind for any accident, injury or damage whatsoever caused to any person or property by me or my dog arising, directly or indirectly, prior to, during, or after the course of this event. I will additionally permit the free use of our names, pictures or likeness in broadcasts, newsletters or promotional materials.

I understand that there may be dogs participating in this event. I understand the terms of this Waiver and Release and by my signature below affirm that I am signing this waiver and release freely and voluntarily.

Tell Us About Your Dog

Your Dog's Name*

Your Dog's Breed*

Your Dog's Weight (in pounds)*

Your Dog's Age*

Your Dog's Sex*

Female
Male

Is Your Dog a Shelter Dog?*

Yes
No

Is Your Dog a Berkshire Humane Society Alumni?*

Yes
No

Miles Your Dog Typically Runs (if any)

Most Miles Your Dog Has Run

Rabies Tag and/or License*

I understand

Please indicate above that you understand that you will be required to show a valid license or rabies tag for your dog on race day.

Please Note!!

Tell Us About Your Dog