Alumni and Public Registration
Warrior Extreme Challenge — April 2, 2017
Download Registration Form
Registration Form Directions
- Enter participant’s name
- Enter participant’s home address
- Enter participant’s e-mail
- Enter participant’s cell phone or easiest point of contact
- Enter birthday (month, day and year)
- Enter gender
- Check participant’s status (alumni or public)
- Check whether participant is registering as an individual, partner or group
*If the participant has a partner, enter their name
*If the participant has a group, enter their names
*All participants must still fill out their own registration form
- Check the registration fee you will be paying ($12 for short sleeve t-shirt and $15 for long sleeve t-shirt)
- Enter the size of the shirt
- Check the type of payment (cash or check)
- Check the box
*If check, enter the check number
*Enter the total amount for registration fee
*If another participant is paying your registration fee, indicate their name
*If you are paying for another participant’s registration fee, indicate the names you are paying for
- Check the box if you have signed the liability waiver. Please send in with registration form and payment.
*The waiver must be signed in order to participate in the event
- Your start time will be communicated with you via e-mail. Time slots are between 11am and 12:45pm.
Send registration forms and liability waivers to the Director of Recreation, Kelly Henrie at email@example.com or send via postal service to address below.
700 College Place
Keiper Rec Center Box 143
Williamsport, PA 17701
Attn: Kelly Henrie
*All checks can be made out to Lycoming College. All questions can be directed to Kelly Henrie at the e-mail address above.