Saturday, April 20, 2013 -- Bruceton Mills, WV / Big Bear Lake Camplands
Big Bear Lake Half Marathon Trail Run
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CONTACT: Heather Parks (phone) 304-216-4467 or 304-379-1211 (e-mail) hbury98@hotmail.com
$25 pre-registered by April 16th, or $30 There after . . . Please make checks payable to Alyeska, Inc.
Mail to:
Heather Parks, c/o Big Bear Lake Camplands
Route 3 Box 204
Bruceton Mills, WV 26525
Name:____________________________________________________________________ Age on 4/20/13: _____________ Date of Birth:____________________________ 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 Half Marathon 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: _______________________________