YMCA of Ithaca and Tompkins County YMCA SPLASH AND DASH For Youth 5 - 12 years Event: Swim as many lengths as you can in 5-10 minutes Run as many laps as you can in 5-10 minutes (Time determined by age) When: Saturday May 2, 2015 Time: 2:30 - Information meeting and sign in 2:45 - Group Photograph 3:00 - Heats begin Fee: $12.00 to benefit the Open Doors Scholarship Fund Tshirts for all participants; limit 50. Please return entry form to the YMCA front desk by Thursday, April 30, 2015. SPLASH AND DASH ENTRY FORM Participant________________________________________Age__________ Parent or Guardian’s Name ________________________________________ Phone #_________________ Email_________________________________ Entry Fee: $12.00 _________ Additional Donation _________ Total Cost _________ T shirt size Kids: sm__ med___large___ WE ARE ASKING FOR VOLUNTEERS TO HELP US RUN THE EVENT SMOOTHLY! I can provide: 1 2 3 4 volunteers for the event. Contact information:______________________________________________________________ Read and sign the waiver form on the reverse side of this sheet. Turn it in to the front desk of the YMCA with entry fee by Thursday, April 30. Things you need to know for the event: Please arrive at the YMCA at 2:30 pm to review heat times and event rules. Group photograph taken at 2:45 pm. For the pool: You can swim any stroke you want. Younger participants and less experienced swimmers may use floatation devices if desired. You will share a lane with one person, and you will have a lap counter. When you finish your laps, you will head over to the gym and start the second part of the event. Transition: Participants will have 5 minutes to get from the pool area to the gym. To keep it simple, children can put shirts and shorts on over their bathing suits. Sneakers are required for the run portion. For the gym: You will need to wear sneakers. You will run around the outside edges of the gym (it will be marked with cones). A volunteer will count your laps. In general:    Parent or guardian of Splash and Dash participant needs to remain at the Y during the event. Bring a towel, water bottle, swim suit (goggles if you want), running clothes, and sneakers. HAVE FUN! Waiver: In consideration for my entry being accepted, I, intending to be legally bound, do hereby, for myself, my heirs, executors and administrators; waive, release, and forever discharge any and all claims and rights for damages which I have or which may hereafter occur to or against the YMCA, for any and all damages which may be sustained by me in connection with my association with or entry in arising out of my traveling to, participating in, and returning from said event. _________________________________ Signature ____________ Date _________________________________ ____________ Parent/Guardian Signature Date YMCA of Ithaca and Tompkins County 50 Graham Rd. West Ithaca, NY 14850 607-257-0101 / Fax: 607-257-5828 / www.ithacaymca.com