Qualified Dog Registration Form 2016 Page 2
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1
2A form must be completed for each dog attending the Renaissance Festival.
OWNER INFORMATION
___________________________________________________________________________________________________
NAME
____________________________________________ _____________________
_____________ _______________
ADDRESS
CITY
STATE
ZIP
__________________________ __________________________ ____________________________________________
CELL PHONE #
HOME PHONE #
E-MAIL ADDRESS
DOG INFORMATION
__________________________________________________ _______________________ ____________________
DOG NAME
BREED
AGE
MALE _______ FEMALE __________ (please Check one)
ALL VACCINATIONS MUST BE CURRENT TO BE ELIGiBLE FOR DOG ADMISSION.
VACCINATIONS
Please list date of most recent vaccination.
RABIES ____/____/_____ TAG #____________ DISTEMPER ____/____/_____ PARVO ____/____/_____
Has your animal ever been deemed dangerous or potentially dangerous at any time in the past? Yes____ No ___
Please list the names and cell phone numbers of any person who may at any time be in control of your pet during the Fest.
GUEST INFORMATION
(You are responsible for your pet and their actions at all times)
_________________________________________________________________________ _________________________
NAME
CELL PHONE #
_________________________________________________________________________ _________________________
NAME
CELL PHONE #
VET INFORMATION
For Pet Gate Use Only
________________________ ______________________________
CLINIC NAME
VET NAME
Tag # __________________
________________________________________________
Photo # _________________
ADDRESS
Paid ___$10 ___$15
____________________________ ________________ _____________
CITY
STATE
ZIP
Rabies Date _____________
_______________________________________
Volunteer ________________
PHONE #
FEES
$10.00
include a current non-returnable 3x3 or larger
photo of your dog. (Cash payment only accepted in person at Pet Gate.)
$15.00
do NOT include a current photo. We will take
the photo of your dog for you at the Pet Gate. (Cash payment only accepted in person at Pet Gate.)
*No refund will be given for the application and processing fees and no refund will be given for the cost of tickets to the Minnesota Renaissance Festival if your Dog is denied
admission or if you are required to leave early.*
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