Rotary World Polio Day

Sunday, October 24, 2010

Rotary Embarcadero Walk, VIP Reception,

San Francisco Ferry Building Lighting

Registration Form

 

Embarcadero Rotary Walk

All Rotary walkers must click to read the Photo Release, and answer the question on this form to participate. Early registration is recommended. 

Entry fee of $25 entitles you to a certificate signed by RI President Ray Klinginsmith, T-shirt, wristband, button. 

VIP Reception $150 ($50 to be donated to Polio Plus -- Club and District to receive credit) space is limited to 800 people early registration is recommended.

Sorry, no refunds!

Please scroll down to see all the content of the form, and be sure to select options, answer questions, and continue to payment selection in order to complete the registration process!
Contact Information
Optional: Do you have a ClubRunner login?
User Name:
Password:
Your Information
First Name:
  
Last Name:
  
Badge Name:
Email:
  
Club Name:

Preferred Phone:
Secondary Phone:
Address 1:
Address 2:
City:
Zip/Postal Code:
Country:
State/Province:
Your Partner/Guest Information
First Name:
Last Name:
Badge Name:
Email:
Club Name:

Preferred Phone:
Secondary Phone:
Address 1:
Address 2:
City:
Zip/Postal Code:
Country:
State/Province:
 
Copyright © 2024 ClubRunner | Privacy Policy | Terms of Use | System Requirements

This event registration form is powered by MyEventRunner, a ClubRunner product.
MyEventRunner is a fully customizable and flexible event registration system.
For more information, visit www.myeventrunnner.com