5K (after 9/1) - $15 _____ 10K (after 9/1) - $15 _____

WVRR member $2.00 discount_______
*make checks payable to: DAYTON FIESTA RUN*

Phone ___________________

e-mail_______________________________

Release: I know that participating in a road race is a potentially hazardous activity. I should not enter
and participate unless I am medically able and properly trained. I agree to abide by any decision of a race
official concerning my being allowed to participate in or complete this event. I assume all risks associated
with participating in this event including, but not limited to: falls, contact with other participants, the effects
of the weather, including high heat and/or humidity, the conditions of the road and traffic on the course, all
such risks being known and appreciated by me. Having read this waiver and knowing these facts, and in consideration
of your accepting my entry, I, for myself and anyone entitled to act on my behalf, waive and release Dayton High
School, and all sponsors, and their respective directors, officers, and successors from all claims or liabilities of any
kind arising out of my participating in this event though that liability may arise out of negligence or carelessness
on the part of the persons named in this waiver. I grant permission to all the foregoing to use any photographs,
motion pictures, recordings, or any other record of this event for any legitimate purpose.