19th Annual Fiesta® Pooch Parade Pre-Registration Form

Saturday, April 29, 2017

Please type into the form on your computer, print it, and sign it. Form, with check included, must be postmarked by April 22 and mailed to address at the bottom of the page to qualify for pre-registration. Registrations postmarked after April 22 WILL NOT be accepted. You may also pre-register on-line by midnight on April 27. If you have questions, please call us at 210-614-6734.

Individual Pre-Registration $25.00       Family Pre-Registration $30.00
Name:
Street Address:
City, State:     Zip Code: (important)
Phone #:     E-mail:

T-shirt size(s):    S         M         L         XL         XXL
(Choose 1 T-shirt for individual registration and 2 for family registration.)

Extra T-shirt size(s):    S         M         L         XL         XXL
(Extra T-shirts may be purchased for $10.00 each. Indicate number of each size.)

Registration Fee:                  $

Amount for Extra T-shirt(s):     $

Additional Donation:             $

Total Amount Enclosed:   $

Waiver of Responsibility
(Must be signed to participate)

In consideration for participation in the Fiesta® Pooch Parade, I/we will indemnify, defend, and hold harmless the Fiesta® Pooch Parade, Therapy Animals of San Antonio, its officers, employees and volunteers from any and all claims, losses, damages including legal fees and medical expenses resulting from any incident or act, whether accidental or intentional, that may occur. Solicitation by paid sponsors only.

Signature:______________________________________________ Date:__________________