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Alumni and Public Registration

Warrior Extreme Challenge — April 8, 2018

Download Registration Form

Registration Form Directions

1. Enter participant’s name
2. Enter participant’s home address
3. Enter participant’s e-mail
4. Enter participant’s cell phone or easiest point of contact
5. Enter birthday (month, day and year)
6. Check participant’s status (alumni or public)
7. 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
8. Check the registration fee you will be paying ($12 for short sleeve t-shirt)
9. Enter the size of the shirt
10. Check the type of payment (cash or check)
11. 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
12. 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
13. 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 henrie@lycoming.edu or send via postal service to address below.

Lycoming College
One College Place
Keiper Rec Center Box 143
Williamsport, PA 17701-5192
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.