2017 Clintonville Quest Rules and Waiver

Clintonville Quest Registration Form
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Event Option*
Team Captain:
Name (First & Last)*
Age*
Email*
Phone Number

Area CodePhone Number
Emergency Contact (Name & Number)*
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Teammate 2 (if applicable):
Name (First & Last)
Age
Email
Emergency Contact (Name & Number)
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Teammate 3 (if applicable):
Name (First & Last)
Age
Email
Emergency Contact (Name & Number)
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Teammate 4 (if applicable):
Name (First & Last)
Age
Email
Emergency Contact (Name & Number)
yesno
Car MagnetPosters in BusinessesFacebookDonatos FlyerFarmers MarketYard SignsFriendClintonville July 4th CelebrationMedia (newspaper, blog, tv, radio)
If you checked "FRIEND" do you know how THEY found out?
Clintonville Quest T-Shirts!!
Every participant gets a T-shirt WITH registration this year! Please select the sizes your team needs.

*Register by August 14th to get your t-shirt DAY OF, otherwise t-shirts will be available for pickup at Inked & Screened at a later date.*
T-shirt Youth XS
T-shirt Youth Small
T-shirt Youth Medium
T-shirt Youth Large
T-shirt Youth XL
T-shirt Adult XS
T-shirt Adult Small
T-shirt Adult Medium
T-shirt Adult Large
T-shirt Adult XL
Cost Breakdown:
TOTAL COST:
Coupon Code:
FINAL TOTAL:
Last year if every participant had given an additional $5 on their registration feewe would have raised $925 MORE for the CRC! Would you consider raising your donation? If so, please add an additional $5, $10, $15, or $20 to your total!
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Your first challenge is to COPY this FINAL TOTAL and paste it into the next payment page in the box "DONATION AMOUNT"!
Should be Empty:

Clintonville Quest Registration Form