Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Division

Division

Standard

Microdog: less than 17 inches as measured from a level table/platform to the withers. MicroDog teams are required to use (any model) Hyperflite Pup discs in competition.

Which Games would you like to play

Freestyle ($12)

Time Trial ($12)

Spot Landing ($12)

Bullseye ($12)

Pairs D & A ($12)

NY State Championship D & A (Sunday) ($25)

If you are playing Pairs D & A, who is your Pairs Partner

First Name

Last Name

LIABILITY WAIVER AND FULL PUBLICITY RELEASE *

For and in consideration of my participation in the Hudson Valley Dog’s Farm’s above-specified event (Event), and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, I the undersigned, intending to be legally bound, do hereby for myself, my heirs, assigns, executors, and administrators, waive and release any and all rights and claims for damages or injuries arising out of or any way related to, my participation in the Event, which I may have against the following parties: The Marvelous Mutts, LLC DBA Hudson Valley Dog Farm, the administrator and owner of the facility hosting the Event, together with the contractors, agents, employees and representatives of each of them. I certify that my canine and I are healthy and fit to participate in the Event. I hereby grant to Hudson Valley Dog Farm the exclusive right to record, broadcast, photograph, film and videotape my performances and related interviews at the Event and to utilize such recordings, broadcasts, photographs, films or videotapes, together with my name, image, likeness, voice, and biographical information, for such publicity promotional or commercial purposes as they may desire. I understand that Hudson Valley Dog Farm may assign the right to use the recordings, broadcasts, images, photographs, film and videotape of my performances, together with my name, image, likeness, voice and biographical information to such person or other entity as they may desire without my further consent or knowledge and I expressly agree to such assignment.

I agree