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2015 Bohemian Alps Run
Name_____________________________________________________

E-Mail Address ________________________________________

Mailing Address_________________________________________

City/State/Zip Code_______________________________________

Age____ Gender_____

T-Shirt Size _______

Race entered:

50 K - Sept 12 [$65.00]_______ Half Marathon Oct 10 [$35.00]_______

4 Mile Oct 10 [$35.00] ______ 1 Mile Kids' Run Oct 10 [$16.00]________

Make Checks payable to: Bohemian Alps Run

Waiver - participant must sign, [parents sign if under 18]

I have been warned that the Bohemian Alps Run is a grueling , grim, and hazardous event, and I am fully aware that I could be injured attempting this run. It is a foolish thing that I am doing, but I am going to do it anyway. I accept full responsibility for the results of my attempt and absolve any and all sponsors, organizers, and supporters of the event from any and all liability related to my attempt to participate in the Bohemian Alps Run.  If I get lost I may be eliminated by Natural Selection.  If I get hurt, it's my own damn fault.

______________________________________________ signature________ date

Mail to:

Bohemian Alps Run
Dale Nielsen
Box 265
213 N. Madison
Brainard, NE 68626
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