Please complete the registration on the reverse side, sign the waiver below, and send with your

entry fee to: A New Leash on Life, Inc. 7949 S I-35 Service Rd Oklahoma City, OK 73140

7949 S I-35 Service Rd Oklahoma City, OK 73149 Local (405) 604-0519 Toll Free (866) 348-6265

WAIVER
In consideration of my participation In the A New leash On Life, Inc. 5K OK River Run and/or 3K dog Jog, I do hereby for myself, my heirs, my executors, administrators and assigns, release and discharge A New Leash On life, Inc., Its employees and volunteers, DG Road Racing Production and other sponsors and officials for all claims of damages, demands, actions whatsoever In any manner arising or growing out of my participation In this event. This release and waiver extends to all claims of every kind or nature whatsoever, foreseen or unforeseen, known or unknown. I also grant permission to sponsors and or agents authorized by them to use any photos, videotapes, motion pictures or any other record of this event for any purpose. I attest and verify that I have full knowledge of the risks Involved in this event and I am medically able and property trained to participate in this event. (Parent or Guardian signs if participant is under 18).

Future Service Dog Roger

5K Sanctioned Run
and

3K Dog Jog Oklahoma River Trails Wiley Post Park 2201 S. Robinson Oklahoma City, OK 73109
A New Leash on Life Inc. is a 501(c)3 Non-profit organization that is about people helping people by utilizing the special abilities of the dogs we train for specific purposes. Our Service Dog and Therapy Dog training programs help Oklahomans with a variety of special needs live more independently, develop confidence, and improve their abilities. Our Companion Dog program benefits the inmates who train them, the people who adopt them and the dogs themselves, who might otherwise remain unadopted.

_______________________________________ SIGNATURE

_______________________________________ DATE

Benefiting

A New Leash On Life, Inc. 405.604.0519

OFFICIAL USE ONLY 5K RUNNER #_____________