Muddy Woofer Cirencester Park

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Team name   First name   Last name   Email address   Phone #   Emergency contact name   Emergency phone #   Category Choose one Ladies 18-25 Ladies 26-35 Ladies 36+ Men 18-25 Men 26-35 Men 36+   Event entry fee increases after August 8, 2020 Event entry fee 20.00 GBP

Want to purchase a T-shirt? NoYes 8.00 GBP T-shirt size Choose one Small Medium Large Extra large Want to purchase a dog bandana? NoYes 5.00 GBP Bandana size Choose one Small Medium Large Extra large Add an extra Participant (8+)  * NoYes   10.00 GBP

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Please review the waiver provided by the event organizer and click the check box below to accept it. Print waiver 1. The signee of this application has read the rules and regulations governing these events and agrees to be bound by them. 2. This licence will be revoked immediately upon failure of the signee to observe all or any of the conditions stated herein. 3. The signee agrees to satisfy themselves of the preparation and condition of the course and accepts that the margins of safety, barriers and obstacles are adequate and suitable for their degree of competence and ability. 4. The signee accepts the responsibility of monitoring all conditions that may materially change the fore mentioned and they participate of their own free will whilst knowing the risks involved. Sign………………………………………..(over 70s) 5. The signee accepts that dangerous conditions plus dangerous, careless and inconsiderate behaviour plus high speeds plus the ground conditions may significantly increase the risk of being killed, permanently disabled or seriously injured in which muddy woofer events and its owners cannot be held responsible. 6. The signee confirms that they are participating in these events under their own free will and if they feel unsafe at any time they will stop and make their way back to the pits. 7. The signee confirms they understand the risks involved with this type of sport and do so at their own risk 8. The signee confirms ‘That I have no known medical condition (including sight impairment) that will substantially affect my ability to control themselves or their animal which I intend to participate’. 9. The signee confirms that ‘Should I be aware of any medical condition be it age related, including prescribed medication or disability which may affect my ability to control themselves, I will present myself to the Chief Medical Officer prior to signing on for a final appraisal’. 10. The signee agrees to keep their dog under control and on a lead at all times and clear up any mess with appropriate bags and place in the correct bins located around the site. 11. The signee agrees to muzzle their dog if they are at all nervous or timid around other animals or people to avoid injury to any third party. 12. The signee confirms that neither themselves or anyone in their household has had an covid symptoms within the last 14 days and if they have any symptoms within 14 days after the event and will contact a member of the Muddy Woofer team to inform them. I accept the terms of the waiver Name of parent or guardian who approves this activity