Race Registration Form

The Second Annual (not-so) Great Serum Run at Fairview Park

December 8th – Costa Mesa

Anything Goes Dog-Powered Races – dog scootering, bikejoring, carting, canicross

Hosted by the Southern California Working Snow Dogs

Events: Please check below all events entering. Entry deadline is December 3, 2007. Cost for one event is $20.00; any additional event will be $10.00
Check Entry choice

Event

Approximate Distance

Cost
  1 Dog Canicross 3 KM $20.00/$10.00
  1 Dog Junior Scooter Race (14 yrs and under) 1 Mile $10.00
  1 Dog Scooter Race 1 Mile $20.00/$10.00
  2 Dog Max Open Race (scooter, bike, sacco or sulky) 2 Miles $20.00/$10.00
  3 Dog Max Open Race (scooter, bike, sacco, or sulky) 3 Miles $20.00/$10.00
  Event T-shirt S M L XL (circle choice) $15.00

TOTAL: _____________

Please make checks payable to Claire Mardesich and mail entry form and check to Three Dog Bakery, 118 S. El Camino Real, San Clemente, CA 92672.

Name of Dog Team: ______________________________________________

Name of Dog Driver: _____________________________________________

Email: _______________________________

Type of rig your dog team will be running with (check one) :

___ Scooter ___ Bicycle ___ Sacco Cart ___ Sulky

___ Canicross (just my running shoes)

PLEASE READ AND SIGN THE WAIVER/AGREEMENT ON THE NEXT PAGE

The Second Annual (not-so) Great Serum Run at Fairview Park

December 8th – Costa Mesa

 

AGREEMENT: I agree to abide by the rules governing this race. I further acknowledge that the race marshall has the final decision and agree to abide by his/her decisions. I agree not to hold the Southern California Working Snow Dogs or its members, the Race Giving Organization or its agents, sponsors, or property owners liable for any injury or accident that may occur during this event. I further agree, that in the event of a cancellation, the Southern California Working Snow Dogs or its members, the Race Giving Organization or its agents, sponsors, or property owners will not be responsible for any expenses incurred as a result of the cancellation other than the refund of the entry fees. I further attest that my dogs are in good health, have received all vaccinations required by state law, and are physically prepared for this event. I will be solely responsible for the conduct and safety of my dogs and handlers.

Name of Dog Team: ______________________________________________

Name of Dog Driver: _____________________________________________

Address: ______________________________________________________

City, St, Zip _______________________ Phone:_______________

Signature (required) ________________________________________

Parent’s Signature for drivers under 18 yrs old ________________________

 

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