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2. Name*
3. Address*
5. Phone #
6. Email*
8. I do hereby represent and warrant that my dog(s) are spayed/neutered, has complete and up-to-date vaccinations, to include current rabies vaccination, and wearing their current rabies tags.*

   1. I Do
10. I understand that if a dog defecates in the pool, the pool will be evacuated of participants, while the pool chemicals are being tested and a proper amount of time has passed.*

    1. I Do
12. I agree to practice responsible pet ownership.*

    1. I Do
14. I understand that the Bedford Parks and Recreation Dog Day at the Pool is a litter-free event. I agree to immediately deposit any trash or dog waste in the proper receptacle.*

    1. I Do
16. I agree not to leave my dog(s) unattended in the park and/or within an enclosed vehicle at any time.*

    1. I Do
18. I release any right and grant full permission to the City of Bedford to use, without payment, any photographs, videotapes, motion pictures, sound recordings, or any other record or information derived from this or any other related event.*

    1. I Do
20. In participating in the Bedford Dog Day at the Pool event, I recognize and acknowledge that injury, illness or damage could occur to my person, children, property, or pet(s) caused by any of the participating pets, participants, premises or property defects, or other causes*

    1. I Do
22. In consideration of the acceptance of this entry and the allowance of myself, my dog(s) and/or my children’s participation in the Bedford Parks and Recreation Dog Day at the Pool, I, for myself and my children, and all others who might otherwise make claim on behalf of me or my children, do hereby voluntarily assume full and sole responsibility for any injury, illness, or damage, accidental or intentional, which may occur to myself, my children, property, or pets directly or indirectly as a result of or during my or my children’s participation in the Bedford Dog Day at the Pool.. *

    1. I Do
24. I, do hereby forever waive, release, discharge, and hold harmless the City of Bedford, Bedford Parks and Recreation, Roy Savage Pool and all sponsors, vendors, veterinarians/veterinary staff, and officials from any and all claims, demands, actions and cause of action whatsoever including, but not limited to, any injury, illness, or damages to myself, my children, property, or pets which might result directly or indirectly from or during my, my pets or my children’s participation.*

    1. I Do
26. I fully understand and agree that failure to fully comply with any and all obligations outlined in this City of Bedford Attendee Agreement and Waiver and/or Roy Savage Pool Rules, will result in my removal from the park and forfeiture of my entrance fee.*

    1. I Do
28. Name Representing Signature*
29. Date/Time*
    Date/Time

    Date/Time
31. Dog Breed (s)*
32. Color*
33. Sex*
34. Name*
36. Dog Breed (s)
37. Color
38. Sex
39. Name
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41. 1. Receive an email copy of this form.
42. Email address

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43. Submit

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