Race for Rights Registration
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1. Default Section

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1. Participant 1 Information

Participant 1 Information Name:
Company/Organization
Address 1:
Address 2:
City/Town:
State/Province:
ZIP/Postal Code:
Country:
Email Address:
Phone Number:

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2. Participant 2 Information

Participant 2 Information Name:
Company/Organization
Address 1:
Address 2:
City/Town:
State/Province:
ZIP/Postal Code:
Country:
Email Address:
Phone Number:

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3. Are you under the age of 18?

(Participants who are under 18 must have their parents/guardians sign their liability waivers, which will be sent to you during the registration confirmation)

Are you under the age of 18? (Participants who are under 18 must have their parents/guardians sign their liability waivers, which will be sent to you during the registration confirmation) Yes

4. T-Shirt size for Participant 1 (T-shirts are unisex so sizes will run large)

T-Shirt size for Participant 1 (T-shirts are unisex so sizes will run large) XS

XXL

5. T-shirt size for Participant 2 (unisex; sizes run large)

T-shirt size for Participant 2 (unisex; sizes run large) XS

XXL

6. Please provide an emergency contact

Please provide an emergency contact Name:
Daytime Phone:
Evening Phone:
Email:

7. Do you speak any other languages?

Do you speak any other languages? Yes

If yes, please specify which one(s)

8. Please indicate any mobility accommodations you might have

Please indicate any mobility accommodations you might have

9. Please indicate any food allergies or dietary requirements you have

Please indicate any food allergies or dietary requirements you have

Thank you for registering for the John Humphrey Centre 1st annual Race for Rights event! A member of the JHC team will contact you shortly to complete your registration including instructions on how to pay your fee and with waiver.

If you have any questions or concerns, please contact RITS@jhcentre.org

Thank you for your participation and we look forward to meeting you!

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Race for Rights RegistrationExit this survey