Go Over the Edge!

May 12 & 13, 2017

Help

Registration

Prerequisites: minimum weight of 100 lbs and a maximum weight of 300 lbs.
Anyone under the age of 18 will need a parent or guardian to sign a liability waiver form.
NO REFUNDS
In the event you are unable to participate or do not meet the $1,000 minimum donation goal, your registration fee will be treated as a donation.
Username
Between 6 and 25 characters

Password
First name
Last Name
E-Mail
Cell Phone Number
T-Shirt Size
Mailing Address - Street
Mailing Address - City
Mailing Address - State
Mailing Address - Zip.
Country, if not US:
Preferred Rappel Time I prefer to rappel in the morning
I prefer to rappel in the afternoon
Donation Goal Amount
Desired Site Name

Registration Fee
$100.00

Credit Card

 
Card Type:
Credit Card Number:
Credit Card Expiration (mm/yy): /
Name On Card:
CVV Value:

Billing Address

 
Address:
City:
State:
Zip Code:
Country, if not US: