Doggie Ditch Day Request Form

Please use the form below to request a dog for Doggie Ditch Day:

Doggie Ditch Day

Volunteer Sign Out Form

Name(Required)

First Last

Email(Required)

Have you participated in Doggie Ditch Day before?(Required)

Yes

Name of the dog your are interested in taking out:(Required)

Please describe where you plan to take the dog and/or activities. (NOTE: If you plan to take the dog to your home, you may only do so if there are NO other dogs in your home.)

Date to pick up dog (Please allow at least 48 hours from request submission [e.g., no same day, next day pick ups]):(Required)

Requested Pick Up Time:(Required)

Date to return dog:(Required)

Requested Return Time:(Required)

Your Phone # (in case of emergency):

Do you agree that the dog will be your responsibility and under your complete care for the duration of the specified dates above?(Required)

Yes