Do your kids love animals, and want to do something to help animals?
Sign them up for the…
For kids 5-12 years old
SMAC ED Center, 548 West Foster Road Time: 10 a.m. - 3 p.m.
Sponsored by the Santa Barbara County Animal Care Foundation
Focus on Fun & Humane Education, Outreach and Awareness
Sunday, September 19th, 2010

The day will include:
Making homemade cat treats & Pleaz say cheese pizza
Movie Review- Thomasina
Pet Overpopulation Session
Making a Difference Craft
Sunday, October 17th, 2010

The day will include:
Making homemade pumpkin dog cookies & Pupperoni pizza
Movie Review- Beverly Hills Chihuahua
Bite Safety Session
Making a Difference Craft
Pumpkin decorating & prizes
Sunday, November 14th, 2010

The day will include:
Making a Difference Craft- Gifts for the animals
Movie Review- The Velveteen Rabbit
All About Bunnies & Choosing the Right Pet Sessions

Making a Difference donation levels for each celebration-

$50 per child (includes a Partner with Paws basic incentive)
$75 per child (includes a Partner with Paws basic incentive & photo with a homeless pet)
$100 per child (includes a Partner with Paws basic incentive, photo with a homeless pet, and a special message from your child
placed on the adoptable Dog, Cat or Bunny kennel of choice). 100% of the proceeds from all Partners with Paws Celebrations are used to better the lives of our County’s homeless and
abandoned animals. Mail registration to SBCACF, P.O. Box 307, Santa Maria, CA 93456 or drop off at the front
desk of the Santa Maria Animal Center, 548 West Foster Road, Santa Maria Voicemail- 805-260-2386

NAME: ________________________________ GENDER:__________________ ADDRESS: _______________________________________________________ CITY: ___________________________________ ZIP: ___________________ BIRTHDATE: ________________ SCHOOL NAME: ________________________ HOME PHONE: _____________________ NAME OF PARENT or GUARDIAN: ______________________________________ WORK PHONE: _____________________ CELL PHONE:____________________ EMAIL: __________________________________________________________ Very important, used for Partners with Paws correspondence Participant Waiver and Release for Minors
______________________________has my (our) permission to participate Partner with Paws Celebration Workshop and
activities on ____________________, 2010, located at the Santa Maria Animal Center from 10:00 a.m. to 3:00 p.m.
1. I understand and acknowledge any risks to my child, by attending the HOPE Workshops. I (we), as parent(s) or
guardian(s) of the minor, do hereby, for my child, myself, my heirs, executors and administrators, remise, release and forever discharge Santa Barbara County Animal Services, the Santa Barbara County Animal Care Foundation, Inc., and all officers, directors, employees, agents and volunteers of the organization, acting officially or otherwise, from any and all claims, demands, actions or causes of action which in any way arise from the minor’s participation in the above noted event. 2. I hereby certify that the minor is in my care, and that to the best of my knowledge and belief said minor is in good health. In case of illness or accident, permission is granted for emergency treatment to be administered. I understand that every effort will be made to contact parents or guardians of students. In the event I cannot be reached, I hereby give permission to the physician selected by the Workshop Staff to hospitalize, secure proper treatment for, and to order injection, anesthesia, or surgery for my child. It is further understood that the undersigned will assume full responsibility for any such action, including payment of costs. I also give permission for first-aid treatment of my child at the HOPE Workshop, by designated personnel. Any accidents and/or injuries must be reported and recorded on site. 3. PERSONAL PROPERTY: Neither the Workshop Staff or Facility shall be responsible for the loss or damage to the 4. DAMAGE: I/We will be responsible for and pay for any damage done by my child, either alone or with others. 5. NO ONE is to leave the Workshop without permission. Permission must be secured BEFORE leaving the grounds. 6. I understand and agree that the Santa Barbara County Animal Care Foundation may subsequently use for publication and/or promotional purpose any picture of my child related to this activity, without obligation or liability to me or my child. I have read the entry information provided and certify compliance with my signature, and agree to the terms of this waiver. This form is deemed confidential, and for the use of staff and medical personnel only. ___________________________________________________ ______________ Parent/Guardian Signature Date Please identify allergies including allergies to food, medications, and drug reactions: Please check over-the-counter medications that may be administered:


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