Ruff Start Rangers Registration Form
Please fill out this form to submit your registration for Ruff Start Rangers. Please submit a separate form for each child if there are multiple children participating. After your information is submitted, a Rangers committee member will be in touch with you regarding additional information. If you have any questions, please reach out to us at rangers@ruffstartrescue.org

Due to the costs of the materials, we encourage each Ranger to donate $25 to help support Ruff Start Rescue and the Rangers Program. If you would like to donate, please click here and note it is for the Ruff Start Rangers Program. If you would like your materials shipped, please consider donating an additional $5-$10 and let us know you'd like them shipped.
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Child's first name *
Child's last name *
Child's date of birth *
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Parent/guardian's first name *
Parent/guardian's last name *
Parent/guardian's email address *
Parent/guardian's phone number (used for picking up materials as needed) *
Mailing Address (street address, city, state, postal code) *
Do you have any affiliation with Ruff Start Rescue? Select all that apply: *
Required
Do you have any pets at home? If so, how many and what species?
How did you hear about this program? *
Ruff Start Rescue Media Release: As a parent/legal guardian of the Participant above, I understand that my child may be photographed and/or featured in video by Ruff Start Rescue and its programs. I hereby grant Ruff Start Rescue permission to use my and/or my child's ("Participant") likeness in any photograph, video, or other digital media ("photo") in any and all of its publications, including web-based publications, without payment or other consideration. I hereby authorize Ruff Start Rescue to edit, alter, copy, exhibit, publish, or distribute these photos for any lawful purpose. In addition, I waive any right to inspect or approve the finished product wherein my and/or my child's likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of any photos. By checking the box and typing my legal name below, I am electronically signing the media release form. I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written signature.
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Required
Your legal (first and last) name (this will serve as your digital signature for the media release above).
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