Online Registration in 2 simple steps

Step 1: Complete the Registration form

Step 2: Pay for your Registration(s)

Submit your Registration by clicking “SEND” you will be redirected to the page where you can make your payment.

You must complete both steps for your registration to be complete.

If you have already registered and want to order a 2023 lighter (price available soon), please email kidsandcancerbenefitrun@gmail.com

Step 1: Complete the Registration form

    Participant Name (driver)

    First Name*
    Last Name*

    Rider (optional)

    First Name
    Last Name

    Address

    Email*
    Street Address Line 1
    Street Address Line 2
    City State/Province
    Postal/Zip Code

    Phone Number

    Area Code and Number

    Shirt Sizes

    Driver T-Shirt Size

    RiderT-Shirt Size (if applicable)