Kulig Registration Form
Fill out the form carefully for registration
Please select your preferred ride time
*
12:30 pm
Number of people over age 2 attending (2 and under are free)?
*
Please Select
1
2
3
4
5
6
Max 6 people
Number of children 2 or under attending (2 and under are free)
1
2
Max 6 people
1st Person 3+
Name
*
First Name
Last Name
Suffix
Please list below any food allergies, physical disabilities, or other medical concerns we should be aware of.
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2nd Person 3+
Name
*
First Name
Last Name
Suffix
Please list below any food allergies, physical disabilities, or other medical concerns we should be aware of.
Collapse Stopper 2
3rd Person 3+
Name
*
First Name
Last Name
Suffix
Please list below any food allergies, physical disabilities, or other medical concerns we should be aware of.
Collapse Stopper 3
4th Person 3+
Name
*
First Name
Last Name
Suffix
Please list below any food allergies, physical disabilities, or other medical concerns we should be aware of.
Collapse Stopper 4
5th Person 3+
Name
*
First Name
Last Name
Suffix
Please list below any food allergies, physical disabilities, or other medical concerns we should be aware of.
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6th Person 3+
Name
*
First Name
Last Name
Suffix
Please list below any food allergies, physical disabilities, or other medical concerns we should be aware of.
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1st Child under 2
Name
*
First Name
Last Name
Suffix
Please list below any food allergies, physical disabilities, or other medical concerns we should be aware of.
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2nd Child under 2
Name
*
First Name
Last Name
Suffix
Please list below any food allergies, physical disabilities, or other medical concerns we should be aware of.
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Contact Information
Primary Contact Name
*
Primary contact for Student
E-mail
*
Mobile Number
-
Area Code
Phone Number
Home Phone Number
-
Area Code
Phone Number
I Agree to receive text messages on the mobile number listed above for emergency notifications and important reminders about this event.
*
Yes
No
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Clear Fields
Please select the number of people 3+ to pay for
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( X )
Kulig
$
15.00
Number of People
1
2
3
4
5
6
Total
$
0.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit Application
Should be Empty: