1. Print out this application.. It may print on 3 pages.
2. After printing the application fill in your information.
3. Bring your registration form to the "Paws & Hearts" .
   Annual Dog Walk At The Westin Mission Hills Resort
   in Rancho Mirage, Saturday, December 4th, 2010.
   Registration begins at 9:00 AM sharp! Walk is at 10:00 AM.
4. You can pre-register by sending in your application and
   donation by mail, or go back to our donations page and make yourdonation on-line by following the simple steps.

The success of any fundraising walk is in the number of walkers who come out and support the organization.

With every passing year we get more and more teams signing up for the walk. Team captains do a great job of getting a group of friends and co-workers to sign up and come out to the walk. This is really easy! Every team captain works to get the biggest team, because the biggest team and the team who turn in the most dollars wins our roving plaque that is engraved with your company or family name, and it is in your possession for the year. Each team captain will get a "Paws & Hearts " baseball cap and tote bag.

Each walker is required to turn in a minimum donation of $25.00 to their team captain who will distribute our commemorative T-shirt and other goodies. But keep in mind, there is no maximum donation per walker or team. The more donated, the greater the chances of winning the plaque.

Registration Form ----Bring to the Dog Walk. Registration begins at 9:00 AM sharp.

Name: ______________________________________________Date: _______________

Address: ________________________________________________________________

City_______________________________State_________________Zip: _____________

Home Phone: (___)____________________Alt. Phone: (_____)_____________________

E-Mail :_________________________________________________________________

T-shirt Size _______Small ______Medium _____Large ______X-Large ____Other Size

Waiver: In consideration of acceptance of my entry, I, my executors, administrators, or assignees, do hereby release and discharge Paws & Hearts, City of Rancho Mirage and The Westin Mission Hills, and other sponsors for any claims of damages, demands, actions whatsoever, in any manner arising out of my participation in said fund raising event. I attest and verify that I have full knowledge of the risk involved in this type of event, and I am physically fit and sufficiently trained to participate in this event.

Applicant's Signature: ____________________________________Date: ____________
________________( Parent signature required of participants under 18 years of age)

Sponsor Sheet --------Fed. Tax ID # 91-2096569

Name________________________________________________________________

Address______________________________________________________________

City____________________________State_____________________Zip__________

Home Phone__________________________Alternate__________________________

Sponsor's Name_________Pledge Amount

Sample:_Myself_________________$25.00

1__________________________________

2__________________________________

3__________________________________

4__________________________________

5__________________________________

6__________________________________

7__________________________________

8__________________________________

Sponsor's Name_________Pledge Amount

9__________________________________

10_________________________________

11_________________________________

12_________________________________

13_________________________________

14_________________________________

15_________________________________

16_________________________________

Total Amount Collected____$__________