The 2nd Annual Keuka Lake 
DASH & SPLASH at The Switz

SIGN UP:
There are three ways to sign-up; on-line, in-person or by mail. Mail-in entries must be postmarked no later than Friday, August 13 and must contain a check or money order.

Sign-up on-line at:

http://dashandsplash.eventbrite.com

Race fee:
$20 for all runners ages 18+
$15 for all runners ages 17 and under.

Entry fee includes a food and beverage item post-race as well as a pair of commerative flip-flops for those who pre-register and while supplies last.

T-shirts 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.

Last year more than 50 pairs were donated. Let's see if we can collect more in 2010!

Print, Sign, & Mail to: Dash & Splash, 118 Monell St., Penn Yan, NY 14527

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 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: __________________________________________________