ENTRY FORM
Register online at www.BolderBOULDER.com for no extra charge or at our store
April 22 through May 26 or mail this form to the address at the bottom.
PERSONAL INFORMATION
crunner
(pace is 11:30 or less)
cjogger
(pace is 14:30 or less)
cjog/walker
(pace is 16:00 or less)
First Name
cTeam KBCO Runner
cwalk/jogger
(in the KBCO wave)
(pace is 17:30 or less)
cwalker
cRun with the Buffs
(pace is over 17:30)
(in the LC wave)
cwheelchair participant
Please Print Legibly
AFFIX BIB # HERE
Proof of sub-68 minute 10K (only if you
want to run in one of the top 31 qualified
waves - no qualification needed to walk,
jog or run in the other 67 waves).
cother proof attached (run since
5/30/16)
cuse my 2016 BolderBOULDER time
cuse my 2016 ColderBOLDER time
Last Name
Email Address
(Necessary for scoring)
Birthdate
Finishers 6 years
of age and older
receive results
Cell Phone
Mailing Address City
State
Sex
(Necessary for scoring)
cMALE
Nickname for Bib (optional)
c FEMALE
Zip Code
Emergency Contact Phone
ACKNOWLEDGEMENT OF RISK, RELEASE OF LIABILITY AND AGREEMENT WAIVER (our lawyers made us say this)
1) I am applying for admission to the BolderBOULDER Race and associated activities (collectively Race Activities@) being fully aware that these activities involve risks. I accept all the risks of participating in the Race Activities, even if they are created by the carelessness or negligence
of a Released Party or anyone else. Risks include physical exertion, large crowds of people where a person may be knocked down and stepped or fallen on, authorized and unauthorized vehicles on the race course, road and surface conditions, and activities in the Memorial Day tribute
in and around the stadium such as sky divers and aircraft. I know there are other risks that are not listed. “Released Parties” as used in this document means BolderBOULDER, Inc., City of Boulder, State of Colorado, the University of Colorado, all sponsors of the Race Activities,
USATF and the governing bodies, directors, officers, representatives, agents, employees, medical personnel, and volunteer staff of each of them). I fully release, discharge and waive any Claims I may have, now or in the future, against the Released Parties even if Claims are based on
the carelessness or negligence of a Released Party or anyone else. (“Claims” as used in this document means any and all liabilities, claims, demands, legal actions, and rights of action for damages, personal injury or death that are related to or in any way connected with participation
in the Race Activities that I or my heirs or personal representative could make). 3) I agree not to sue Released Parties for Claims, even if the Claims arise from the carelessness or negligence of a Released Party or anyone else. I agree to indemnify (reimburse for any loss) and hold
harmless each Released Party from any loss or liability (including any reasonable attorneys fees they may incur) defending any Claim made by me or by anyone making a Claim on my behalf, even if the Claim is alleged to or did result from the carelessness or negligence of a Released
Party or anyone else. 4) I am aware that there is no obligation for any person to provide me with medical care during the Race Activities. If medical care is rendered to me, I consent to that care if I am unable to give my consent for any reason at the time that the care is rendered. I
am aware that it is advisable to consult a physician prior to participating in the race. If I have consulted one, I have taken the physician’s advice. 5) I agree not to consume alcoholic beverages during any of the Race Activities if I am under the age of twenty-one years. If I am over that
age, I agree not to consume enough alcohol to become intoxicated. 6) I grant my permission to BolderBOULDER, Inc., the sponsors of the Race Activities and any transferee or licensee of any of them, to utilize any photographs, motion pictures, videotapes, recordings and any other
references or records of the Race Activities that may depict, record, or refer to me for any purpose, including commercial use by BolderBOULDER, Inc., its sponsors and their licensees. 7) I agree to abide by the rules of the Race Activities. I am aware that the rules prohibit baby strollers/
joggers, pets on the course, and any wheeled equipment, such as bicycles or inline skates. I acknowledge that, if I violate any of these prohibitions or other rules, I may be removed from the course and the permission for me to participate in the Race Activities may be withdrawn by
representatives of BolderBOULDER, Inc. However, I am also aware that certain people will be permitted on the course with wheelchairs or other forms of conveyance for disabled person(s) with special prior arrangement. Others may violate the rules, adding to the risks of participation.
8) No warranties or representations have been made to me about the Race Activities which are not stated on this form. I understand and intend that this document act as the broadest and most inclusive assumption of risk, waiver, release of liability, agreement not to sue and indemnity
as is permitted by the laws of the State of Colorado. If any portion of it is held to be invalid, I agree that the rest of it shall continue in full force and effect. The singular of nouns and pronouns in this document includes the plural and the plural includes the singular. I agree that this
agreement was made in Boulder, Colorado and that the laws of the State of Colorado shall govern its interpretation and enforcement. 9) If the participant is under 18 years of age, the parent agrees to the following statements: As a parent or guardian of the participant, I authorize the
child to participate. I also join in the statements and agreements made by the participant in this document. I also agree that, in the event participant or anyone acting on his or her behalf should make any Claims, I will provide the indemnity and hold harmless described in paragraph 3.
Please read waiver and sign here:
X
X
Signature
Date
Parent or Legal Guardian's Signature (if you are under 18) Date
Parent or Legal Guardian Printed Name
RACE PACKAGE FEES AND PAYMENT (No refunds or transfers)
RACE PACKAGES Packages include tag timing, calendar/runner's guide and collectible snack bag. No substitutions for other merchandise.
c I do not want my shirt: c Donate value to the CU Scholarship fund OR c Donate my shirt for humanitarian aid
c Short Sleeve Race Package
Men's – S c M c L c XL c XXL c
Women's – S c M c L c XL c
Kids' – M c L c
c Long Sleeve Race Package
Unisex – S c M c L c XL c XXL c
c Skechers Premium Tech Shirt Package
Men's – S c M c L c XL c XXL c
Women's – S c M c L c XL c
c Bolder Race Package: Short Sleeve, Long Sleeve and Tech Shirt (Select all sizes above)
Standard Price
Kids (14&U) Senior (65+) Active Military
Thru 2/28 3/1-5/14 5/15-5/28
May 29
PRICING
Thru 2/28 3/1-5/14 5/15-5/28
May 29
Short Sleeve Race Package
$55
$65
$70
$40
$50
$55
$50
$35
Long Sleeve Race Package
$60
$70
$75
$45
$55
$60
$55
$40
Skechers Premium Tech Shirt Package (fits like regular tee)
$70
$80
$85
$55
$65
$70
$65
$50
Bolder Race Package: Short Sleeve, Long Sleeve and Tech Shirt $85
$95
$100
$70
$80
$85
$80
$65
EXTRAS
c Join us in supporting the University of Colorado’s Championship Cross Country Team
c Memorial Day Back Bib (to run in honor of someone who has served or is currently serving - no charge)
c BB Mobile Locker Ticket (drop your extra gear near the start and we'll have it waiting near the finish)
Card No.
c Visa c Mastercard
Exp. Date
Optional Donation $
Optional Mobile Locker ($3) $
Optional Shipping
$
TOTAL $
CVV (on back of card)
/
$
R
HOW DO YOU WANT TO RECEIVE YOUR PACKET? You will be notified by email or mail when your packet is ready.
c I will pick up my race packet at a selected location (no charge - circle location choice from options below)
c OR, Mail my packet (Register by 5/8/17) c $7.00 for Short Sleeve, Long Sleeve or Technical Shirt Package c $11.50 for BOLDER Package
METHOD OF PAYMENT c Check payable to BolderBOULDER
Package
Price
Billing Zip
Signature
YOUR BOLDER GUARUNTEETM
If you sign up for the 2017 BolderBOULDER and can't run, we will roll your registration over to the 2018 race for only $15.
PACKET PICK-UP LOCATIONS (Circle appropriate location; Walk-in registration available at BolderBoulder Store and Sports Exhibit only; Do NOT mail entries to
these locations; visit www.bolderboulder.com for addresses and entry/pick-up deadlines for each location.)
Boulder County & Broomfield
Denver Metro
BolderBOULDER Store
(303) 444-7223
Runner's Roost
Louisville – (303) 926-7653
Boulder Running Company
Greenwood Village – (303) 770-5131
Race Weekend (May 27-28) at the
SportsEXHIBIT (Pearl Street Mall) or
Race Day (May 29) near the Start
(303) 444-7223
Flatirons Running, Inc.
Boulder – (303) 554-7837
Road Runner Sports
Westminster – (303) 465-6022
Shoes and Brews
Longmont – (720) 340-4290
Road Runner Sports
South Denver – (303) 802-4434
Boulder Running Company
Boulder – (303) 786-9255
MAILING ADDRESS (NO WALK-IN REG): BOLDERBOULDER
Runners Roost
Denver – (303) 759-8455
•
5500 CENTRAL AVENUE #110
•
Boulder Running Company
Cherry Creek – (303) 847-4123
Runners Roost
Ft. Collins – (970) 224-9114
Boulder Running Company
Littleton – (303) 932-6000
Foot of the Rockies
Cheyenne – (800) 603-7866
Runners Roost
Lakewood – (303) 991-1851
Northern Colorado and Wyoming
Colorado Springs
Altitude Running
Ft. Collins – (970) 377-8005
Boulder Running Company
Colorado Springs – (719) 278-3535
BOULDER, CO 80301
•
WWW.BOLDERBOULDER.COM
•
303-444-RACE