MVCS Fun Staff and Board Dog Show: Entry Form - Martha’s Vineyard Community Services

Dog's Name*

Age*

Rabies Tag Number*

Rabies Tag Expiration Date*

Vet*

Dog License Number*

Town Issued*

Owner's Name*

Contact Phone*

Contact Email*

Classes to Enter: (pick any that apply or you would like to enter)

Ribbons will be awarded for 1st, 2nd and 3rd place in these classes.

Awards will also be given for: Best In Show Judge Would Most Like to Take Home (Biased Award)

Liability Waiver

MVCS Fun Staff & Board Dog Show and Martha’s Vineyard Community Services, Inc., their affiliates, successors, officers, directors, trustees, staff, employees, volunteers are not responsible for any injury, loss or damage of any kind sustained by me or my dog during my participation or volunteering for the MVCS Fun Staff & Board Dog Show or any events, activities or operations related to the MVCS Fun Staff & Board Dog Show.

By participating in the MVCS Fun Staff & Board Dog Show, I agree:

TO ASSUME AND ACCEPT ALL RISKS arising out of, associated with or related to my and my dog’s participation or volunteering in the event;

TO BE SOLELY RESPONSIBLE for any injury, lost or damage I or my dog might sustain while participating or volunteering in the event;

TO HOLD HARMLESS AND INDEMNIFY Martha’s Vineyard Community Services, Inc. from any and all liability for any damage to the personal property of, or personal injury to, any third party resulting from my participation or volunteering in the event and all related activities; and

TO GRANT PERMISSION for any photographs, videos or other images taken of me and/or my dog, during the event to be used by Martha’s Vineyard Community Services, Inc., the media or the general public without compensation to me, including permission to copyright, publish or use the photographs, video or other images in any format for any and all lawful purposes and that my consent is not required for publications.

I acknowledge that my dog has been socialized with both people and other dogs and has not shown any aggression towards either.

I agree that the laws of the Commonwealth of Massachusetts shall govern this agreement.

I acknowledge that I have read the rules and regulations for this event.

Acknowledgement

I acknowledge that I have read this agreement, that I have executed this agreement voluntarily and that this agreement is to be binding upon myself, my heirs, executors, administrators and representatives, in the event of my death or incapacity.

Signature*

Printed Name*

Date*