PTO and Educational Foundation

2017 DRAGON DASH REGISTRATION FORM - Saturday, October 7th, 2017 at 9am

THE EVENT:  Runners & Walkers of all levels are invited to this fun event beginning at Indian Hill continuing through picturesque River Hills.  Choose from 5K Run or 1 Mile Run / Walk.
AFTER THE DASH: Cheer on the littlest ones with their own Fun Run. Then celebrate with food, drink, music, bounce houses and more.  Awards given to top finishers & kids dash winners.
PRE-REGISTRATION INCLUDES: Race bib needed for Post Dash Party, 2017 Dragon Dash t-shirt, race bag with goodies, post dash party & games and good family fun.  Sign up by 9/18 to be guaranteed a shirt.
3 WAYS TO REGISTER:
Return this form to Maple Dale or Indian Hill ~ www.TheDragonDash.com ~ In Person at the Race 10/7 @ 8am

Family name _________________________________     Email _________________________________________

Participants name and shirt size:       Youth S-L         Adult S-2XL                                                   

Name _______________________  YS  YM  YL  AS AM  AL  AXL  A2XL

Name _______________________  YS  YM  YL  AS AM  AL  AXL  A2XL

Name _______________________  YS  YM  YL  AS AM  AL  AXL  A2XL

Name _______________________  YS  YM  YL  AS AM  AL  AXL  A2XL

Name _______________________  YS  YM  YL  AS AM  AL  AXL  A2XL

Name _______________________  YS  YM  YL  AS AM  AL  AXL  A2XL

(1) Non-Refundable Entry Fee: 
Individual Adult Registration $25
Individual Child Registration (4-17) $10
Family Registration (includes 2 adults and up to 4 children) $80
All prices are through 9/18/17, after that prices go up $5 per person
* Children under 4 are free (t-shirt not included unless you pay child registration fee)

Total Entry Fee: $ __________________

(2) Optional Tax Deductible Donation:
I would also like to make an additional Tax Deductible Donation  $____________  

(1) + (2) = TOTAL ENCLOSED: $_____________________
Check Payable to:  “The Dragon Dash” and return to school
Participant Signature or Signature of Guardian if participant is under 18:​​
_________________________________________________

EVENT WAIVER: In signing and submitting the registration form, you are agreeing to the following event waiver:  In consideration of the acceptance of my entry to participate in The Dragon Dash, (hereinafter referred to as “the Event”) on October 9, 2017, for me, my child and all those whom I am legally able to bind, I hereby release and forever discharge the Maple Dale-Indian Hill School District and their respective employees, volunteers, agents and any other entities and individuals who are in any way connected with the Event, from any liability or claims for any injury or illness that I or my minor child(ren) sustain during my participation in or that is in any other way related to the Event.  I understand that the Event involves physical activity and I represent that my child and I are in sound medical condition to participate without risk to ourselves and others.  I understand that risk of injury may accompany such participation and acknowledge that this release is being relied upon by the above persons in permitting me and my child to participate.  I agree to assume and pay my own, and my child’s, medical and emergency expenses in the event of injury, illness, or other incapacity regardless of whether I authorized such expenses. PERMISSION:  I understand, as parent/legal guardian of the child(ren) named on this registration form, that there are times when the local media requests the opportunity to videotape, take photographs and/or interview children within the Maple Dale Indian Hill School District.  These requests usually involve news stories about the school, education in general or current events happening in the city.  I further understand that should my child participate in the Event, it would be on a voluntary basis and that no monetary benefits will be provided to me.  I hereby grant the various media operations the ownership of and the right to use, publish, and copyright my child’s picture, portrait and likeness in advertising, promoting and publicizing the Event in any manner or form throughout the world in perpetuity.