Cannonball Run Watersport Olympic Registration Form
Customer Details:
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
*
example@example.com
How did you hear about Cannonball Run?
*
Please Select
Facebook
Website
Magazine
Radio
Other
Please Specify
*
Donation Charity
Please Select
CADV
COMC
Dream Factory
Lake West Chamber of Commerce
Laurie Elks Club
Laurie Sunrise Beach Rotary Club
Livabilities
LOWA
Raising Butterflies
Sharing and Caring
Teammates Name (Only complete if you are choosing Relay or Pong Contest)
First Name
Last Name
Events (Choose as many as you would like) Make sure to add all registration fees below.
Please Select
individual paddleboard (Youth - up to 13)
individual paddleboard (Young Adult - 14-30)
individual paddleboard (Adult - 30 and up)
relay paddleboard
individual kayak (Youth - up to 13)
individual kayak (Young Adult - 14-30)
individual kayak (Adult - 30 and up)
relay kayak
pong team contest
Suggestions if any for further improvement:
My Products
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Individual Paddleboard Registration Fee
1 person
$
25.00
Quantity
1
2
3
4
5
6
7
8
9
10
Relay Paddleboard Registration Fee
2 people
$
50.00
Quantity
1
2
3
4
5
6
7
8
9
10
Individual Kayak Registration Fee
1 person
$
25.00
Quantity
1
2
3
4
5
6
7
8
9
10
Relay Kayak Registration Fee
2 people
$
50.00
Quantity
1
2
3
4
5
6
7
8
9
10
Pong Contest
2 people
$
50.00
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card
Submit
Should be Empty: