Greenway Challenge | Whitinsville, MA

Price Schedule

	thru 09/05/2019	thru 09/20/2019
Individual (solo) Participant	$120	$150
2-4 Person Team	$200	$225
5+ Person Team	$275	$300

Categories*

Individual (solo) Participant - $120.00

Individual Participant is allowed (1) Support Team Member that MUST register below

2-4 Person Team - $200.00

All Team Members must participate in at least one course segment

5+ Person Team - $275.00

Maximum of 8 Team Members; All Team Members must participate in at least one course segment

Additional Team Member

All Team Members must participate in at least one course segment

Support Team Member

Support role only for Individual (solo) Participants

Donation Only

Participant Information

Team Selection

Team*

Team Secret Code

Setup Team Information

Team Name *

Team Secret Code *

We will send you an email with instructions and a link to register.
You can forward this email to the members of your team.

Email *

Participant First Name *

Participant Last Name *

Participant Birthdate *

Participant Gender *

Male

Female

Country Address

Street Address *

City *

State *

Zip Code *

Phone *

Emergency Contact Name *

Emergency Phone *

Affiliated Club, Company or Organization add new team

select or enter a team name

Team Division *

Individual Participants must choose either Male or Female Division

Co-Ed

Female

Male

Corporate (5+ Teams only)

Liability Waiver

I have read and agreed to the waiver*

Are you 18 or older?*

18 or older Under 18

Photo Release

I have read and agreed to the waiver*

Are you 18 or older?*

18 or older Under 18

Free Event Shirt

Shirts are available whiles sizes last - first come first serve! Guaranteed if registered by 9/5

Woman S

Women M

Women L

Women XL

Men S

Men M

Men L

Men XL

Men 2XL

Make a Donation

Whitin Community Center

Donation $
(learn more about this cause)

The Whitin Community Center is a 501(c)(3) non-profit organization serving the people of the Blackstone Valley with health and fitness programs, child care, and youth outreach programs.

Payment Summary

Discount, Tracking, or Charity Code

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Price

Discount

$ (-)

Donation

Handling

Total

Payment Information

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Cardholder First Name

Cardholder Last Name

Cardholder Address

Cardholder Country

City, State, Zipcode

Credit Card #

Exp. Date /

CVV Code

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