MyEventRunner - Event Public Fill

Optional: Do you have a ClubRunner login?

User Name:

Password:

Your Information

First Name:

Last Name:

First Name to put on ID Badge:

Rotary Club Name (If a Rotarian):

For Students - Name of School:

Best way to contact You::

Email:

Best Phone Number for speaking to you ( CALLS).:

Best Phone Number for TEXT Messages. (Type NONE if you do not text):

Person to Contact in Case you have an Emergency:

Emergency Contact Person's Phone Number:

My Mailing Address:

City:

State/Province:

Zip/Postal Code:

For Housing Assignments, please select your gender::

I consent to the collection, storage, and use of my information by Rotary District 5390 as described in this Privacy Policy. I understand that I may receive emails regarding this event and other relevant information, and can opt out at any time.

Group:
Counselor C1
Counselor C2
ADULT Staff (All staff/counselors who are 18 and older)

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