Complete one form for each participant

Register by April 14th and the service fee of $1.50 will be waived! Late registrations (after April 14th) are not guaranteed a t-shirt or memorial sign.


T-Shirt: Recognizing those in Recovery

We would like to recognize those in recovery by including their name on the t-shirt. Complete the optional field below to recognize yourself or a loved one in recovery.

Memorial Sign: Recognizing Loved Ones Lost

Loved ones who we have lost to addiction will be recognized on a Memorial Sign. Complete the fields below to recognize your lost loved ones.

**NOTE** To submit additional names, please send an email to [email protected] detailing the information requested in the fields above.

Reg Fox by Webconnex
Secure Online Registration Powered by RegFox