Dayton Fiesta Run Entry Form – (Make checks payable to: WVRR)

Phone ______________________________ e-mail_______________________________________

Waiver: 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. I also understand that the entry fee is non-refundable. No one may enter this event without signing this official waiver.

Participant’s Signature ___________________________________________ Date______________

Signature of parent or guardian if under 18 ___________________________ Date______________