Registration Form Sat

Event Date: August 16August 17, 2014Sun

Time: 10:30 am to 5:00 pmBoth

Where: Bever Park Pool

Please Print Clearly

Name: ______

Address: ______

City/State/Zip: ______

Telephone: ______Email: ______

Check this box if you would like to be added to our e-newsletter. We send it out about once a month and it contains information about K9COLA, the off-leash parks, local dog friendly events, treat recipes, and other dog related articles.

Check this box to learn how to volunteer with K9COLA.

Dog’s Name / Dog’s Breed/Description / M/F / Vaccination Records Checked? (Initials) / Day(s) / Fee
Total
How did you hear about this event? Postcard Billboard Friend News Facebook
Other______(Newspaper, Volunteer emails, etc.)
Payment method (Circle): Cash Credit Card* Check** # ______

Pre-registration$9.00/dog/day

  • Phone in your registration (have credit card ready)! Call: 319-286-5731 between 8 am -5 pm weekdays & fax form, signed waiver, and vaccination records to 286-5732 or mail: Cedar Rapids Parks and Recreation Department, 2000 Mt. Vernon Rd. SE, Cedar Rapids, IA 52403 (mailed registrationsmust be postmarked by 8/07/14).
  • Stop by Ambroz and register in person. Walk-in Pre-registration closes Wednesday August 13that 5:00 p.m.

Registration will also be available the day of the event for $13.00/dog/day.

  • Volunteers can receive free entries: contact Jill @ to help!
  • 1 Dog/Adult Handler; Proof of Rabies, Distemper, & Parvo from Vet Required
  • 2014 Off-Leash Park tags will NOT be accepted as proof of vaccination
  • No children under 10 yrs old and under 48” tall allowed in pool area
  • Other Rules apply. Be sure to print the rules and waiver form also

Payment Method Notes:

*Credit Card (Pre-registration Only!) Visa, Master Card, & Discover Accepted. Know your Number and Expiration Date.

** Checks

Preregistration: City of Cedar Rapids

The day of the event: K9COLA

Questions:

  • K9COLA Contact: Marie Appel (319) 560-1673 or
  • City of Cedar Rapids Parks & Rec. Department: Carolyn Hamilton at 319-286-5731

Rules

  • Only well-mannered dogs and their (well-mannered) handlers are allowed to participate.
  • Dogs exhibiting aggressive behavior will be asked to leave with no refund given.
  • Proof of current vaccinations (including Rabies and Parvo/Distemper from your vet is required. A Rabies tag is NOT enough!) 2014 OLA permit tags will NOT be accepted as proof.
  • Each dog must be accompanied by a responsible adult handler age 18+
  • Handlers will be allowed in the pool only to help their dog in and out; no human swimming!
  • Limit one dog at a time per handler; use caution when leaving extra dogs in vehicles!
  • For their safety, children under age 10& 48 inches will not be admitted through the gate.
  • No dogs in heat, or under four months old
  • Clean up after your dogs! (And take them out of pool area to poop.) Bags are provided.
  • Dogs must wear flat buckle/snap collars when they are off-leash (No prong, choke or training collars will be allowed except to walk dogs to the entrance gate of pool). Collars will be available for purchase or rental the day of the event. Full body harnesses and dog life vests are okay too
  • All dogs must be off leash once admitted and drinking water will be provided.
  • Pool toys will be provided; to minimize risk of guarding, leave your dog’s toys at home
  • No human or dog food/treats in pool area; handlers may have non-alcoholic beverages
  • No glass containers
  • Lifeguards will be on duty for humans but will not assist dogs
  • Anyone entering the pool area will be required to sign a release of liability form

Release of liability

I acknowledge that I voluntarily have applied to participate and use, with or without my dog(s), the City of Cedar Rapids’ Bever Pool for K9Splash!. I understand that the act of unleashing my dog(s) and being physically present inside the pool area necessarily involves risks of injury to me, other people, my dog(s), and other dogs. I understand these risks are entirely my responsibility. I expressly assume these risks. I am aware of the risks and hazards inherent upon entering the pool area and I choose to voluntarily enter the premises, knowing the conditions might become more hazardous and/or dangerous for myself and/or dog(s) and I voluntarily assume all such risks, loss, damages, or injury that may be sustained by entering the pool.

By signing this release of liability and using the pool, I hereby fully and forever release, indemnify, and discharge the City of Cedar Rapids, the City of Cedar Rapids Parks and Recreation Department, K9COLA Citizens for Off-Leash Areas, and their volunteers, vendors, employees and agents from any claims, demands, damages, rights of action or causes of action present or future, whether the same be known or unknown, anticipated or unanticipated, resulting from or arising out of my use or intended use of the pool. I fully and forever release and discharge the City of Cedar Rapids, the Cedar Rapids Parks’ and Recreation Department, K9COLA Citizens for Off-Leash Areas, and their volunteers and vendors, employees and agents from any and all negligent acts and omissions in the same.

I also grant permission to these organizations to use pictures or videos taken of me, my family, and/or my dog(s) during participation in this event. I understand these images may be used for promotional, news, research, and/or educational purposes, including on the Internet. I understand that images posted on the Internet can be downloaded by any computer user. I waive my right to inspection or compensation.

I have carefully read this release of liability and understand and fully agree with its contents. Do not sign if you do not understand or do not agree with its terms. Anyone entering the pool area must sign this waiver. Parent(s) please list your minor child(ren)’s name(s). Date: ______

Name(s) (please print): ______

Signature(s): ______