Dandelion Registration 16 .pdf

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5K Dandelion May Run/Walk
(proceeds benefit Zachary Davis Memorial Fund)

Date: Sunday, May 8
Time: 1 p.m.
Location: Breitenbach Wine Cellars, 5934 Old State Route 39, Dover, Ohio 44622
Course: Scenic route through Amish Country (slightly hilly).
Registration is in the purple barn beside the winery. The run begins at the intersection
of Old Route 39 and Broad Run Dairy Road. Go west on Old Route 39 to Spooky Hollow. Turn right, then turn right again on Prysi Road. Continue on Prysi Road to Broad
Run Dairy Road. The finish is on Old State Route 39.
Registration: $20 if received by April 25. $25 after and on race day.
Day of event registration begins at 11:30 a.m.
Age Categories: Both male and female.
Under 20, 20 - 29, 30 - 39, 40 - 49, 50 - 59, 60 +
Awards: Cash prize to top male and female.
Gift certificates and medals to each age category winner.
Music, food, t-shirt and Sangria at the finish.

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - RUN REGISTRATION

Checks and Payment to: Zachary Davis Memorial Fund - PO Box 543 - Dover, Ohio 44622
Name: __________________________________________ Age: ____________

Male / Female

Address: _______________________________________________________________________
Email: ____________________________________ Phone: ______________________________
Shirt Size: S M L XL

Are you part of the Tusc. Valley Challenge? yes / no

In consideration of the acceptance of this entry to the Dandelion May Run, I waive myself and my
heirs and assigns, any and all claims for damage which I might have against Breitenbach Wine Cellars
or any sponsors of the run. As a result of any and all injuries, which might be received during the
above mentioned event, I arrest and verify that I have full knowledge of the risks involved in this event
and I am physically fit to participate.
Participant’s Signature: ____________________________________________________________
Parent or Guardian (if under 18): ____________________________________________________

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