NAKASEC VA 2019 "Pursuing our Dreams"Fundraiser:Team Registration
Please complete one form per team (5 people total). Forms and payment are due by May 23rd, 2019
Team registration fee is $20 per Youth and $40 per Adult. Registration fee payment includes event admission and free t-shirts for your entire team.

Questions? Contact Miae Bok at mbok@nakasec.org or 703-256-2208.

Email address *
Team Name *
Your answer
Team Captain Contact Information (Name, Phone, Email, Mailing address ) *
Your answer
T-shirt Size for Captain *
Team Member #1 Contact Information (Name, Phone, Email, Mailing address ) *
Your answer
T-shirt Size for Member #1 *
Team Member #2 Contact Information (Name, Phone, Email, Mailing address ) *
Your answer
T-shirt Size for Member #2 *
Team Member #3 Contact Information (Name, phone, Email, Mailing address ) *
Answer N/A if you do not have a third member.
Your answer
T-shirt Size for Member #3 *
Answer N/A if you do not have a third member.
Team Member #4 Contact Information (Name, Phone, Email, Mailing address ) *
Answer N/A if you do not have a fourth member.
Your answer
T-shirt Size for Member #4 *
Answer N/A if you do not have a fourth member.
Please list any dietary restrictions your team may have:
Your answer
Payment Info
Team registration fee is $20 per Youth registered and $40 per Adult Registered.

Submit registration fee online at https://krcla.ourpowerbase.net/civicrm/contribute/transact?reset=1&id=19 or mail payment to: NAKASEC, 4304 Evergreen Lane, Suite 104, Annandale, VA 22003

Please note “NAKASEC VA 2019 Fundraiser” in contribution note.

Once payment is completed, we will send you a email confirming your teams registration!

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