Event Registration

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Event
ME STRONG 5k walk/run
East Indiana Avenue
DeLand, FL 32724
United States
Saturday, January 28, 2017
8:00 AM
Participant Information
Note: Fields marked with an asterisk (*) are mandatory.
First Name:*
Last Name:*
Date of Birth:*
Gender:*
Street Address:*
Apt#:
City:*
Country:*
State/Province:*
ZIP Code:*
Email Address:*
Re-type Email:*
Emergency Contact Name:*
Emergency Contact Phone Number:*
Participant Questions
 1. Are you a cancer survivor?
Give-Away Information
 

Donation
 
 
I would like to make a donation.
Other Amount:
Donate on Behalf of:
Donate in Memorial of:
Giving Option
 Please consider absorbing the donation processing fee so that 100% of your donation goes to our cause.
Discount Code
If you have a discount code please enter it here and hit the "Apply" tab.    Apply >
Purchase Total
Registration Fee:  $ 
Donation:  $ 
Registration Processing Fee:  $ 
Total:  $ 
Total After Discount:  $ 
         
 
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This feature will create a team for only this race. If there are multiple races within this event and some of your team members will be doing another race, someone on your team will need to create your team for that race as well.
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Selecting to Create a Team here will enable this feature only for the run/walk. If you'd like to create a team for fundraising purposes, please select 'Yes' to the "Do you want to become a fundraiser?" question below and complete the form that opens up.
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Selecting to Join a Team here will enable this feature only for the run/walk. If you'd like to join a team for fundraising purposes, please select 'Yes' to the "Do you want to become a fundraiser? " question below and complete the form that opens up.
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This feature allows you to create a team. The Team Captain needs to enter basic information for all team members and can then pay for themself. The registration system will then send each team member a hot link and instructions on how to complete their own registration.
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First Name Last Name Race Name Race Fee Total
No records found
 
Total Amount: $0.00
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Your first/last name and email address match a registration already on file. Continuing with this as is will result in a duplicate registration. If you want to check your registration status, please visit the My Registration tab.