Keuka Lake DASH & SPLASH Events

SIGN UP:
Registration for the 2012 Keuka Lake DASH at The Switz will be available starting in April 2012.

Race fees:
$20 for all 5K runners ages 18+
$15 for all 5K runners ages 17 and under
$10 for all 1-Mile fun-run runners

Entry fee includes a food and beverage item post-race as well as a pair of commerative flip-flops for those who pre-register while supplies last. A limited number of t-shirts will be available for sale at the registration tent on the day of the event.

LOSE THE SHOES!

Don't forget - bring your tired old running shoes with you and donate them to our shoe drive.

Print, Sign, & Bring to the Keuka Lake DASH at The Switzerland Inn

Last Name: ___________________________________ First Name: _________________________

Street: ________________________________________ City: ______________________________

State: _______  Zip Code: ______________  Phone: (___ ___ ___)___ ___ ___ - ___ ___ ___ ___

Age on August 22nd: _______ Birthday: _______________  Event (Circle one):  5K   or  1-Mile

E-Mail: __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ _ _

Shoe Size: ________________   Gender (Circle one): Male  or  Female

Waiver:

I understand that a road race is a potentially hazardous activity. I should not enter unless I am medically able and properly trained. I assume all risks associated with this event including but not limited to contact with other participants, foul weather, water hazards, traffic and road conditions; all such risks being accepted by me. I, for myself and anyone entitled to act on my behalf, waive and release The Switzerland Inn and its employees, all event sponsors and Keuka Comfort Care Home and all its employees and board members and volunteers, and the Keuka Lake Dash and Splash race committee and all volunteers, the whole of Steuben County and the whole of Yates County from all claims and liabilities of any kind arising out of my participation in this event.

Signature: __________________________________________

Date: _________________________

Under 18 Parent/Guardian Signature: ___________________________________________________