Step 1 of 2 50% Rim2Rim RegistrationName* First Last GenderMaleFemalePhone*Email* Birth Date* MM slash DD slash YYYY Age on Race Day Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Work Phone* Race Choice and T-Shirt InfoRace Choice*Rim2Rim Race | 7.5 Mile RUN | SINGLE PERSONRim2Rim Race | 7.5 Mile RUN | TEAM REGISTRATIONRim2Rim Race | 7.5 Mile WALK | SINGLE PERSONRim2Rim Race | 7.5 Mile WALK | TEAM REGISTRATION1/2 Rim Race | 3.25 Mile RUN | SINGLE PERSON1/2 Rim Race | 3.25 Mile RUN | TEAM REGISTRATIONIf you register as a walker, you CANNOT run at any time during the race.)What Team or Company are you With?* Would you like to order a T-shirt?Pick OneYesNo(All of our T-Shirts are an additional $10)T-Shirt Size*Pick OneXSmallSmallMediumLargeXLargeXXLarge(All of our T-Shirts are Unisex Fitting)Would you like a Rim2Rim Medal?*Pick OneYesNo(Additional $10)Would you like to donate $5 or more?Pick OneYes, donate $5Yes, but I'd like to specify the amountNoDonation Amount* $5 Donation Price: Total $0.00 Waiver*I, hereby for myself, my heirs, executor, and administrators waive and release any and all rights and claims for damages I may have against the organizers and sponsors of the Rim2Rim Race, for any and all injuries I may suffer in connection with my participation in this event. I agreeSignature*Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Expiration Date Security Code Cardholder Name CAPTCHAPhoneThis field is for validation purposes and should be left unchanged. Δ
