Dog Wash Participant Registration

Join us for our annual Charity Dog Wash on Saturday, April 26th from 1-3PM at our Newberry location! Treat your pup to a spa day or enter in our raffle for prizes from local businesses all while supporting those affected by cancer. All proceeds from this event will be donated to the American Cancer Society.

THIS ONLINE PRE-REGISTRATION ALLOWS SUBMISSION OF RABIES CERTIFICATE FOR DATE OF EVENT

*Please note we require a donation of $10 per bath or $15 per bath/ear cleaning package. All donations benefit the American Cancer Society and will be collected at the entrance to the event on the day of the event. Cash and Debit/Credit cards will be accepted.

Dog Owner's Name

Address

Date of Birth

YYYY

Cell Phone

Work Phone

How did you hear about our event?

Website/Internet Search

Facebook

Instagram

TV/Commercial

Radio

Friend/Relative

NAH Newsletter

City of Gainesville

Other

Name of Pet #1:

Date of Birth / Age, if known:

Breed:

Sex:

Male

Female

Date of Last Rabies Vaccine:

YYYY

Animal Hospital that gave last Rabies Vaccine:

If you do not upload your dog's Rabies certificate below, we will call their veterinarian to confirm they are up to date

Name of Pet #2, if applicable:

Date of Birth / Age, if known:

Breed

Sex:

Male

Female

Date of Last Rabies Vaccine:

YYYY

Animal Hospital that gave last Rabies Vaccine:

If you do not upload your dog's Rabies certificate below, we will call their veterinarian to confirm they are up to date

Name of Pet #3, if applicable:

Date of Birth / Age, if known:

Breed

Sex:

Male

Female

Date of Last Rabies Vaccine:

YYYY

Animal Hospital that gave last Rabies Vaccine:

If you do not upload your dog's Rabies certificate below, we will call their veterinarian to confirm they are up to date

Name of Pet #4, if applicable:

Date of Birth / Age, if known:

Breed

Sex:

Male

Female

Date of Last Rabies Vaccine:

YYYY

Animal Hospital that gave last Rabies Vaccine:

If you do not upload your dog's Rabies certificate below, we will call their veterinarian to confirm they are up to date

Name of Pet #5, if applicable:

Date of Birth / Age, if known:

Breed

Sex:

Male

Female

Date of Last Rabies Vaccine:

YYYY

Animal Hospital that gave last Rabies Vaccine:

If you do not upload your dog's Rabies certificate below, we will call their veterinarian to confirm they are up to date

RABIES VACCINATION CERTIFICATE

In order to complete this online pre-registration, please upload a rabies vaccination certificate that will be valid on April 26th, 2025, the day of this event. All pets are required to have a valid Rabies Vaccination Certificate showing they are vaccinated for rabies and fully immunized on the date of this event. If you do not pre-register online, and choose to bring your Rabies Certificate with you on the day of the event, please make sure the certificate is valid to prevent your dog from being denied access to the event.

Upload Rabies Vaccination Certificate here:

Delete all uploads

Choose files or drag here

PARTICIPATION AGREEMENT

I agree that this instrument is for registration and not for insurance coverage. I further agree to hold harmless Newberry Animal Hospital Group, its agents, and the employees from any and all liability of every kind and sort which may occur because of participation in this program except for that caused solely by gross negligence of either. It is understood and agreed that Newberry Animal Hospital Group reserves the right to dismiss any participant for just cause. I further agree to return any and all property issued to me, upon the expiration of this activity, or whenever I have ceased participating in this activity. At these said programs and events it is possible for photographs to be taken. I give permission for these photographs to be used for publicity purposes for Newberry Animal Hospital Group. This release form is completed and signed of my own personal free will and with full knowledge of its significance. I have read this release and understand all of its terms.

Signature of Participant: