Rock Creek 2024 100 RTKC: Registration Form

1

Full Name* This field is required.

First Name

Last Name

2

Email* This field is required.

3

Phone Number

4

If the phone number is a cell number, confirm if you would like to receive text message updates.(this is a possible pilot program this year)

Yes

5

Please choose the registration type:If the free Radon Test Kit option is at 0 left, please select Waiting List

6

Would you like to pick up your Free Radon Test or have it delivered

Pick up from: Rock Creek Fairgrounds, Kettle Valley S Rd.

I would like to have my kit delivered

7

If you want it delivered, please provide your address and any instructions for drop off:

8

Additional comments: