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Saturday, April 24, 2010 -- Bruceton Mills, WV / Big Bear Lake Camplands
Big Bear Lake 20K Trail Run (iPO Event Id#: 12598)

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Name:_________________________________________________________ 

Age on 4/24/10: _____________  DOB:____________________________

Male/Female _____________     

Address: _______________________________________________________

City, State:________________________________   Zip:_____________

Emergency Contact Information

Name: ______________________________  Phone:_____________________
Waiver of Liability: I Hereby release from liability the Big Bear Lake Campgrounds and Alyeska Inc. All sponsors, race officials, and anyone connected in anyway with the 2010 Big Bear Lake 20k run and for any injury or ailment resulting from my participation in the above stated race. I further state that I am aware that this race is a strenuous activity and I have prepared properly for my participation in it.
Signature:__________________________________________________
Parent or guardian signature if under 18 

Date: _______________________________ 

Entry Fees: $20 pre-registered by April 19th, or $25 There after 

Please make checks payable to Alyeska, Inc. 

Heather Parks
c/o Big Bear Lake Camplands
Route 3 Box 204
Bruceton Mills, WV 26525