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RACE REGISTRATION FORM

Race your wiener dog, corgi, basset hound or mixed mutt/all breeds for FREE!

There is NO cost to race your dog, however you must purchase tickets to watch for entry.

Let's GET STARTED...

Which dates and/or locations are you interested in racing at:

Your First Name

Your Last Name

Cell Phone:

Address

City:

State:

Zip Code:

Dogs Full Name:

Age:

Weight:

Breed or Mix:

Is your Dog Full Breed? * Required

YES!

NO!

Is your Dog Male or Female? * Required

MALE

FEMALE

Has your dog raced before: * Required

YES!

Is your dog up-to-date on shots: * Required

YES!

Does your dog exhibit bad behavior: * Required

YES

NO!

Do you agree to the terms and conditions: * Required

YES!

What's your dogs favorite toy:

What's your dogs best personality traits:

Please upload two (2) individual pictures of your dog below:

Upload File

Upload supported file (Max 15MB)

Upload File

Upload supported file (Max 15MB)

Message

I have read and agree to the terms & conditions.

Thanks for submitting your application! Your dog registration application has been received. You will receive a confirmation email soon!

www.rcpalmer.com | Phone: (714) 202-4504

IMPORTANT LINKS:

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Click Here to Get Tickets

Clayton-Palmer, Lp. dba RC Palmer & Company

WC Nationals, West Coast Wiener Nationals dog races are operated by Hartley J Partners, Lp.

WEST COAST WIENER NATIONALS, ORIGINAL WIENER DOG RACES are Service Marks of Justin & Ryan Clayton-Palmer

CONTACT INFO:

Business Address:

3857 Birch Street, #26
Newport Beach, CA 92660

Phone:

(714) 202-4504

Email:

Justin@Clayton-Palmer.com

*RSVP’ing does not guarantee entry

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