Name_____________________________________________________
E-Mail Address
________________________________________
Mailing Address_________________________________________
City/State/Zip
Code_______________________________________
Age____ Gender_____
T-Shirt Size _______
Race entered:
50 K - September 30 [$80.00]_______ Half Marathon Sept 2 [$45.00]_______
4 Mile Sept 2 [$45.00]
______ 1 Mile Kids' Run Sept 2 [$25.00]________
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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