HERA Climb for Life Registration

Online registration is no longer available. Please register at the event.

Part 1 of 2: Must be filled in COMPLETELY

Prefix:

Evening Phone:

Day Phone:

Email:

Date of Birth:
mm/dd/yyyy format

Age:

Gender:Female Male

First Name:

Last Name:

Address Line 1:

Address Line 2:

City:

State/Province:

Other:

Country:

Other:

Postal Code:

T-Shirt Size: Small Medium Large X-Large
— Preferred size dependent on availability and not guaranteed —

Choose One Category

Category #1 Regular Participants
$50 Climber/Boulderer

Check One
I will be Climbing Bouldering

Skill Level?
Sport Lead TR
Trad Lead TR
Boulder

Category #2 Learn to Climb (Novice)
Learn to Climb is FULL

You are a novice if you have never climbed or have only climbed a few times in the gym or outdoors. We suggest that you consider taking a basic class at a local gym before you come so that you have a working knowledge of belaying, rapelling and tying in. You will have more fun if you do.

Comments

Yes, I have read the Fundraising section and I commit to climbing feet and raising $ from personal sponsors. I will mail the contributions I gather to the HERA Ovarian Cancer Climb for Life.

Online registration is no longer available. Please register at the event.

Registration fees and forms due by September 6, 2005.
After 09/06/2005- register at the event:
September 15, 3-6pm
2092 E. 3900 South
Salt Lake City, Utah
The Rockreation side of Black Diamond Complex,
east parking lot.