PreAuthorize Contact:

Register to Participate in Event

First Name*

Last Name*

Email*

Cell Phone *

Company Name

Street

City

Zipcode

Occupation

Employer

Spouse Fullname

Spouse Occupation

Spouse Employer

Acknowledgement of Waivers

Date of Birth

Emergency Contact

Emergency Contact Number

Family Team Name

If under 18, Parent or Guardian eSignature

Parent Name for Participant Under 10

Parent/Guardian Name if under 18

Pet Name

Team Name

Total Distance Family (In Miles)

Total Distance Individual (In Miles)

Total Distance Team (In Miles)

Youth <10

Name on Card

Card

Opt-in to cover the service fees associated with your purchases

Cell Phone (optional)

AUTHORIZE CARD

* Registering your credit card does not charge your card at this time. Preauthorization of your credit card makes purchasing or checking out at your event easy and quick. By registering (or preauthorizing) your credit card here, you're giving the event organizer permission to charge your card for items that you agree to purchase or donations you agree to make while at the event. Service fees will be applied in addition to any total if you have opted in to cover those fees above.