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2. Application and Liability Waiver

   I hereby agree to participate as a member for the City of Rosenberg Animal Control & Shelter (RACS) Pup Run Running Club (the “Club”), and in doing so I agree to comply with all the rules and regulations established by RACS. I understand that failure to do so may result in my immediate termination as a member. As a member, I agree to do my best to represent RACS to the public in an accurate and professional manner.

   I acknowledge that my services are provided strictly on a volunteer basis, without par or compensation of any kind, and without liability of any nature on behalf of the RACS, all services to be performed at my own risk. I have decided to be a member of the Club. I acknowledge that running in and volunteering for runs, events, and races with the Club are potentially hazardous activities that may result in injury or death. I, therefore, voluntarily and willingly assume all risks, whether known or unknown, that may be associated with being a member of the Club including, but not limited to, the following: falls, contact with other members, the effects of the weather (including, but not limited to, extreme temperatures, high humidity, rain, hail, ice, sleet, and snow), traffic, and the conditions of the road or trail. I agree that I will not participate in any Club events, runs, or races unless I am medically able to do so and properly trained. By my signature, I certify that I am medically able to perform all activities associated with the Club including handling large dogs, and am in good health, and I am properly trained.

   I understand that animals being handled in the club must remain on leash at all times with proper spacing between other participants. I recognize that in handling animals there exists a risk of injury including physical harm caused by the animals. I understand that if staff or club organizers believe I cannot safely handle a dog during a run, I may be asked to swap dogs or to participate without a dog. On behalf of myself, my heirs, personal representatives, and executors, I hereby agree to indemnify and hold harmless the City of Rosenberg from any and all claims of cause of action that may arise out of participation in the Club. I waive any right of action I have against the aforementioned entities in consideration as a volunteer for the City of Rosenberg Animal Control & Shelter.

   I realize that in my capacity as a volunteer with the City of Rosenberg, I may come into contact with confidential information. I do hereby agree to protect this information to the best of my abilities as a volunteer and to no divulge it during or after my service as a volunteer.

4. First Name
5. Last Name
7. Date of Birth
9. Address (City, State, Zip)
11. Phone Number
12. Email Address
14. Driver's License Number
15. DL State
17. Emergency Contact Name and Relationship
19. Emergency Contact Phone Number
21. I agree that

    1. I am capable and healthy enough to participate in physical activities like walking/jogging/running.
    2. I am comfortable walking/jogging/running with dogs weighing up to 80lbs.
    3. I understand that I may be asked to run without a dog if staff or club organizers notice safety risks.
    4. I grant permission to use my photographs, motion pictures, recordings or any other record for any legitimate purposes for the Club.
23. Electronic Signature Agreement

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

    1. I agree.
25. Electronic Signature
Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

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