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The Twelfth Annual
Ocean Lakes High School
DOLPHIN DASH 5K RUN/WALK
for Charity
Check #
Saturday, May 9, 2015
9:00 a.m.
Ocean Lakes High School, Virginia Beach, VA
Race #
Runner, Walker and Volunteer Registration Form
The race is open to all students and staff of Ocean Lakes High School, their families, and the
Ocean Lakes Community.
All proceeds of the event go to Liv On Foundation, therefore, there is a registration fee
for volunteers and runner/walkers.
Please see http://livonfoundation.org/ for more information on this charity that is close to the Ocean Lakes Community.
Circle One:
RUNNER
WALKER
VOLUNTEER
Registration. During the weeks of April 20, 2015 – April 23, 2015 registration forms will be collected in the cafeteria
and gym foyers and student activities office between 7:10-7:20 a.m. Registration can also be mailed. Cost is $12.00
and checks should be made payable to OLHS. The signed registration form and money must be turned in at the time
of registration. Registration will also be held race day, May 9th, in the gym for $15.00 - t-shirts cannot be
guaranteed. There will be NO REFUNDS. If the race is cancelled due to inclement weather, it will not be
rescheduled. The prize drawings will be held even if the race is cancelled. Race packets must be picked up May 7th
and an announcement will be made during first block for students. Students may pick up race packets for family
members. Additional pick-up will be race day at 8:00 a.m. in the OLHS gym.
Awards. Participants will be given a door prize ticket as they cross the finish line for the multiple prize drawing at
the conclusion of the race. The top three finishers in each category will receive an award for placing in their
respective categories. All runners and volunteers will receive a race t-shirt (if registered by April 23rd).
Divisions/Individual Age Groups. Age as of race date. The Ocean Lakes student divisions include:
(male/female) Freshman, Sophomore, Junior, and Senior and Faculty/Staff Male and Faculty/Staff Female. For NonOcean Lakes siblings: 11- under and 12 and over. The adult divisions include: (male/female) 19-29, 30-39, 40-49
and 50-up. Teams consist of four members. A male team, female team and/or mixed team (2 males/2 females).
Teams may consist of a mixture of adults and students and one team can medal. Teams will NOT be eligible for
individual age division’s awards. Entries must have a team name and register together.
*** Race is open to the first 400 participants ***
* Refreshments served after the race, Door Prizes available *
PLEASE PRINT NEATLY (BOTH SIDES)
NAME ____________________________(AGE on Race DAY)________
ADDRESS _______________________________________________
HOME PHONE # ______________ E-MAIL _______________________
Block 2B Room # ______
2B Teacher _______________
T-SHIRT Size
____ Small
____
____
____
____
Medium
Large
X-Large
XX-Large
(size is not guaranteed)
Divisions:
Individual Age Groups: MALE FEMALE (Please circle gender and class/age)
OL Student: Freshman, Sophomore, Junior, Senior OL Faculty/Staff
Non- OL Student: 11- under, 12- over Adult: 19-29, 30-39, 40-49, 50-up
Or Team: (Teams may consist of mixture of adults and students) MALE, FEMALE, MIXED (2 males/ 2 females)
TEAM NAME (if it applies):__________________________________ (must have a team name) OVER
OCEAN LAKES HIGH SCHOOL
DOLPHIN DASH 5 K RUN
SATURDAY, May 9, 2015
Ocean Lakes High School, Virginia Beach, VA
Race time: 9:00 a.m.
The race is open to all students and staff of Ocean Lakes High School and their families.
This is a school-sponsored event for the benefit Liv On (to raise money for Colon Cancer Research).
PARTICIPANT AGREEMENT
While participating in this event, I will accept responsibility for maintaining good conduct and
appearance, and I will follow directions at all times. I agree to abide by the Ocean Lakes High
School Code of Conduct at all times while participating in this school activity.
I give permission for _____________________________________ to participate in the event
(Print Name)
described above.
I know that running a race is a potentially hazardous activity. I should not enter and run unless I am medically able and properly
trained. I agree to abide by any decisions of a race official relative to my ability to safely complete the run. I assume all risks
associated with running this event including but not limited to: falls, contact with participants, the effects of the weather,
including extreme cold and ice, traffic and conditions of the road, 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 Ocean Lakes High School, Virginia Beach City Public Schools, City of Virginia Beach, State of
Virginia, race officials, volunteers, and all sponsors, their representatives and successors from all claims and liabilities of any kind
arising out of my participation in this event. I grant permission to all of the foregoing to use any photographs, motion pictures,
recordings, or any other record of this event for any legitimate purpose. This is a road race conducted under the rules set forth
by the Dolphin Dash committee at Ocean Lakes High School and I understand the race is not intended for baby joggers, baby
strollers, skates, skateboards, headphones, or animals on leashes, and I will abide by these guidelines.
1) Participant Signature ___________________________________ Date ______________
2) Parent/Guardian Signature ______________________________ Date _______________
3) Emergency Contact _________________________________
(Please Print Name Neatly)
__________________
(Phone Number)
All Applications will be processed in the order received. Incomplete forms cannot be accepted. Registration forms mailed to
Ocean Lakes High School, RE: Lindsay Clauer/Dolphin Dash; 885 Schumann Dr. 23454, must be postmarked by April 23, 2015.
Thank you!