The Shops of Prairie Village Wiener Dog Derby Registration

Please only fill out one form per dog.

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Email

Dogs Name

Dogs Breed

Dogs Weight

Dogs Age

Only dogs permitted in the track and in each race are dachshunds. All canines must be currently licensed and up to date on all shots including rabies vaccination. Humans, please bring your pet's vaccination record and we will give you a number and collect an event waiver at registration. Dogs must be leashed when not participating in a race.

**Event happens rain or shine. If lightning no alternate date.