Register For
Derby Dash 5k

Williamstown, KY 41097

Registrant #1

Who are you registering? *


By selecting this box, you are indicating that you are the parent/guardian of the person you are about to register. Additionally, if the child is under the age of 13, you are consenting to the collection and use of the information about the child for the purpose of the registration as described in our privacy policy.

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Basic Info

To be able to access / edit your registration.

Additional Information

Format: mm/dd/yyyy
Used for age group calculations
Format: ###-###-####

Address

Choose Your Event *

$18.00

$20.00

Open to ages 16 and under.

$10.00

Waiver

In consideration of the acceptance of my entry, I hereby waive, discharge and  release on behalf of myself, my heirs, executors and assigns, all claims of any nature arising from my  participation in the Derby Dash, and do hereby release the Fitness for Life Around Grant County, the city of Williamstown, all sponsors, workers, officials and volunteers from any claim whatsoever arising from my participation in this event. I agree to abide by all rules for participation and acknowledge that FFLAG may refuse or return my entry at its discretion. I understand the risks involved in such a run/ walk, and that I am physically fit and have trained adequately in preparation. I also give my permission to Fitness for Life Around Grant County to use any photographs, video or other recordings of me that are made during the course of this event. I understand that my information (name, age, city of residence) may be posted online and/or in other media when posting the results of the run/walk. I also understand that the entry fee is nonrefundable.

 




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