CrossFit for a Cure 2018 Registration
May 19, 2018 at 9:00 am
Address: 45945 Center Oak Plaza #175, Sterling, VA 20166
Contact jaclyn.racicot@gmail.com for any questions about the Event or Relay for Life of Loudoun County.

The 2nd CrossFit for a Cure is hosted by CrossFit Sterling and Jaclyn Francis/Team Walk n’ Roll of Relay for Life of Loudoun County. 100% of proceeds will go towards the ACS RFL. Thank you for your support!

Registration is a two-step process: this form and the registration payment through the link listed at the bottom. Please make sure to complete all steps and information for both teammates. This information will be used solely for the Event and will not be shared.

Team Name *
Your answer
Name of Participant One *
Your answer
Name of Participant Two *
Your answer
Tell us whom in honor or memory your team is crushing cancer (can be generic, "my uncle", or specific, "John Smith") *
Your answer
Email Address of Participant One *
Your answer
Email Address of Participant Two *
Your answer
Date of Birth for Participant One *
I understand that I must be over the age of 14 to participate. Under the age of 18 must have signed Parental consent.
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DD
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YYYY
Date of Birth for Participant Two *
I understand that I must be over the age of 14 to participate. Under the age of 18 must have signed Parental consent.
MM
/
DD
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YYYY
Gender of Participant One *
Gender of Participant Two *
T-shirt Size of Participant One *
T-shirt Size of Participant Two *
Participant One: How experienced are you with CrossFit? *
Participant Two: How experienced are you with CrossFit? *
If you currently CrossFit, what is your affiliate(s)? *
Your answer
*
Required
To complete registration, please make your team's $50 tax deductible donation to Jaclyn Francis/Team Walk n' Roll on the American Cancer Society's Relay For Life donation page here: https://secure.acsevents.org/site/SPageServer/?pagename=relay_donate_now&PROXY_TYPE=20&PROXY_ID=36155611&FR_ID=88903 *
An email payment confirmation will be sent from Relay for Life.
Required
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