EVENT REGISTRATION

To register for our April 6, 2018 "Beers & Gears" fundraising event, please fill out the form below and click the "submit" button when completed. You will have the opportunity to pay online after submitting the form. Please note that bold fields are required.

First name:
Last name:
Email:
Address 1:
Address 2:
City:
State:
Zip code:
Phone:
Enter number of tickets: (defaults to 1 if no quantity entered)
Send my ticket via: Email   Postal Mail
Questions/
comments:
 

NOTE: If you have trouble reading the challenge phrases, keep clicking on the small red reload button until you see phrases you can read.

  <-- CLICK HERE TO REGISTER

DONATIONS ONLY

If you are not registering for an event above, and would simply like to make a donation to Healthy Kids, Happy Kids, please use the button below: