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Stomp Out Suicide 5K Tshirt Order Form

Date August 17, 2024
Time 9:00 am-12:00 pm
LocationGoodview Park, Wyoming, MN
Event TypeAnnual

Event Information

This form is to place orders for 2024 Stomp Out Suicide event t-shirts. This form will be open until 9/3/24 at 8 a.m. After 9/3, we will ship the shirts to your home. Pricing below includes shipping and handling.

We also encourge you to contribute to the event via JustGiving!

Stomp Out Suicide T-shirt Order

"*" indicates required fields

This field is hidden when viewing the form

Virtual

Adult T-shirt

Price:

Quantity

Total

Adult Registration (Virtual)

Price:

(Ages 18+) Includes t-shirt to be shipped to you.

Quantity

Virtual Total

Child T-shirt

Price:

Quantity

In Person Child Total

Child Registration (Virtual)

Price:

(Ages 2-17) Includes t-shirt to be shipped to you.

Quantity

Virtual Child Total

Additional Donation

Thank you for considering an optional donation!

$25

$50

$75

Other Amount

Custom Donation Amount

Additional Donation Amount

Price:

Additional Donation Amount

Price:

Additional Donation Amount

Price:

Total due:

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Organization Information

Organization Name

Billing Address

Name*

First Last

Email*

Cell Phone*

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Payment Details

Credit Card Information*

Cardholder Name

Card Details

Adult T-shirt #1

Name*

First Last

Email*

Cell Phone*

Address*

Same as billing

Street Address City State / Province / Region ZIP / Postal Code Country

T-Shirt Size*

This field is hidden when viewing the form

Birthdate

Month

Day

Year

(MM/DD/YYYY)

This field is hidden when viewing the form

How did you hear of this event?

This field is hidden when viewing the form

I am walking in honor/memory of

This field is hidden when viewing the form

Join Team

This field is hidden when viewing the form

Waiver*

I agree to the waiver of liability.*

Adult T-shirt #2

Name*

First Last

Email*

Cell Phone*

This field is hidden when viewing the form

Address*

Same as billing

Street Address City State / Province / Region ZIP / Postal Code Country

T-Shirt Size*

This field is hidden when viewing the form

Birthdate

Month

Day

Year

(MM/DD/YYYY)

This field is hidden when viewing the form

How did you hear of this event?

This field is hidden when viewing the form

I am walking in honor/memory of

This field is hidden when viewing the form

Join Team

This field is hidden when viewing the form

Waiver*

I agree to the waiver of liability.*

Adult T-shirt #3

Name*

First Last

Email*

Cell Phone*

This field is hidden when viewing the form

Address*

Same as billing

Street Address City State / Province / Region ZIP / Postal Code Country

T-Shirt Size*

This field is hidden when viewing the form

Birthdate

Month

Day

Year

(MM/DD/YYYY)

This field is hidden when viewing the form

How did you hear of this event?

This field is hidden when viewing the form

I am walking in honor/memory of

This field is hidden when viewing the form

Join Team

This field is hidden when viewing the form

Waiver*

I agree to the waiver of liability.*

Adult T-shirt #4

Name*

First Last

Email*

Cell Phone*

This field is hidden when viewing the form

Address*

Same as billing

Street Address City State / Province / Region ZIP / Postal Code Country

T-Shirt Size*

This field is hidden when viewing the form

Birthdate

Month

Day

Year

(MM/DD/YYYY)

This field is hidden when viewing the form

How did you hear of this event?

This field is hidden when viewing the form

I am walking in honor/memory of

This field is hidden when viewing the form

Join Team

This field is hidden when viewing the form

Waiver*

I agree to the waiver of liability.*

Adult T-shirt #5

Name*

First Last

Email*

Cell Phone*

This field is hidden when viewing the form

Address*

Same as billing

Street Address City State / Province / Region ZIP / Postal Code Country

T-Shirt Size*

This field is hidden when viewing the form

Birthdate

Month

Day

Year

(MM/DD/YYYY)

This field is hidden when viewing the form

How did you hear of this event?

This field is hidden when viewing the form

I am walking in honor/memory of

This field is hidden when viewing the form

Join Team

This field is hidden when viewing the form

Waiver*

I agree to the waiver of liability.*

Adult T-shirt #6

Name*

First Last

Email*

Cell Phone*

This field is hidden when viewing the form

Address*

Same as billing

Street Address City State / Province / Region ZIP / Postal Code Country

T-Shirt Size*

This field is hidden when viewing the form

Birthdate

Month

Day

Year

(MM/DD/YYYY)

This field is hidden when viewing the form

How did you hear of this event?

This field is hidden when viewing the form

I am walking in honor/memory of

This field is hidden when viewing the form

Join Team

This field is hidden when viewing the form

Waiver*

I agree to the waiver of liability.*

Adult T-shirt #7

Name*

First Last

Email*

Cell Phone*

This field is hidden when viewing the form

Address*

Same as billing

Street Address City State / Province / Region ZIP / Postal Code Country

T-Shirt Size*

This field is hidden when viewing the form

Birthdate

Month

Day

Year

(MM/DD/YYYY)

This field is hidden when viewing the form

How did you hear of this event?

This field is hidden when viewing the form

I am walking in honor/memory of

This field is hidden when viewing the form

Join Team

This field is hidden when viewing the form

Waiver*

I agree to the waiver of liability.*

Adult T-shirt #8

Name*

First Last

Email*

Cell Phone*

This field is hidden when viewing the form

Address*

Same as billing

Street Address City State / Province / Region ZIP / Postal Code Country

T-Shirt Size*

This field is hidden when viewing the form

Birthdate

Month

Day

Year

(MM/DD/YYYY)

This field is hidden when viewing the form

How did you hear of this event?

This field is hidden when viewing the form

I am walking in honor/memory of

This field is hidden when viewing the form

Join Team

This field is hidden when viewing the form

Waiver*

I agree to the waiver of liability.*

Adult T-shirt #9

Name*

First Last

Email*

Cell Phone*

This field is hidden when viewing the form

Address*

Same as billing

Street Address City State / Province / Region ZIP / Postal Code Country

T-Shirt Size*

This field is hidden when viewing the form

Birthdate

Month

Day

Year

(MM/DD/YYYY)

This field is hidden when viewing the form

How did you hear of this event?

This field is hidden when viewing the form

I am walking in honor/memory of

This field is hidden when viewing the form

Join Team

This field is hidden when viewing the form

Waiver*

I agree to the waiver of liability.*

Adult T-shirt #10

Name*

First Last

Email*

Cell Phone*

This field is hidden when viewing the form

Address*

Same as billing

Street Address City State / Province / Region ZIP / Postal Code Country

T-Shirt Size*

This field is hidden when viewing the form

Birthdate

Month

Day

Year

(MM/DD/YYYY)

This field is hidden when viewing the form

How did you hear of this event?

This field is hidden when viewing the form

I am walking in honor/memory of

This field is hidden when viewing the form

Join Team

This field is hidden when viewing the form

Waiver*

I agree to the waiver of liability.*

Child T-shirt #1

Name*

First Last

T-Shirt Size*

This field is hidden when viewing the form

Birthdate

Month

Day

Year

(MM/DD/YYYY)

This field is hidden when viewing the form

How did you hear of this event?

This field is hidden when viewing the form

I am walking in honor/memory of

This field is hidden when viewing the form

Join Team

This field is hidden when viewing the form

Waiver*

I agree to the waiver of liability.*

Child T-shirt #2

Name*

First Last

T-Shirt Size*

This field is hidden when viewing the form

Birthdate

Month

Day

Year

(MM/DD/YYYY)

This field is hidden when viewing the form

How did you hear of this event?

This field is hidden when viewing the form

I am walking in honor/memory of

This field is hidden when viewing the form

Join Team

This field is hidden when viewing the form

Waiver*

I agree to the waiver of liability.*

Child T-shirt #3

Name*

First Last

T-Shirt Size*

This field is hidden when viewing the form

Birthdate

Month

Day

Year

(MM/DD/YYYY)

This field is hidden when viewing the form

How did you hear of this event?

This field is hidden when viewing the form

I am walking in honor/memory of

This field is hidden when viewing the form

Join Team

This field is hidden when viewing the form

Waiver*

I agree to the waiver of liability.*

Child T-shirt #4

Name*

First Last

T-Shirt Size*

This field is hidden when viewing the form

Birthdate

Month

Day

Year

(MM/DD/YYYY)

This field is hidden when viewing the form

How did you hear of this event?

This field is hidden when viewing the form

I am walking in honor/memory of

This field is hidden when viewing the form

Join Team

This field is hidden when viewing the form

Waiver*

I agree to the waiver of liability.*

Child T-shirt #5

Name*

First Last

T-Shirt Size*

This field is hidden when viewing the form

Birthdate

Month

Day

Year

(MM/DD/YYYY)

This field is hidden when viewing the form

How did you hear of this event?

This field is hidden when viewing the form

I am walking in honor/memory of

This field is hidden when viewing the form

Join Team

This field is hidden when viewing the form

Waiver*

I agree to the waiver of liability.*

Child T-shirt #6

Name*

First Last

T-Shirt Size*

This field is hidden when viewing the form

Birthdate

Month

Day

Year

(MM/DD/YYYY)

This field is hidden when viewing the form

How did you hear of this event?

This field is hidden when viewing the form

I am walking in honor/memory of

This field is hidden when viewing the form

Join Team

This field is hidden when viewing the form

Waiver*

I agree to the waiver of liability.*

Child T-shirt #7

Name*

First Last

T-Shirt Size*

This field is hidden when viewing the form

Birthdate

Month

Day

Year

(MM/DD/YYYY)

This field is hidden when viewing the form

How did you hear of this event?

This field is hidden when viewing the form

I am walking in honor/memory of

This field is hidden when viewing the form

Join Team

This field is hidden when viewing the form

Waiver*

I agree to the waiver of liability.*

Child T-shirt #8

Name*

First Last

T-Shirt Size*

This field is hidden when viewing the form

Birthdate

Month

Day

Year

(MM/DD/YYYY)

This field is hidden when viewing the form

How did you hear of this event?

This field is hidden when viewing the form

I am walking in honor/memory of

This field is hidden when viewing the form

Join Team

This field is hidden when viewing the form

Waiver*

I agree to the waiver of liability.*

Child T-shirt #9

Name*

First Last

T-Shirt Size*

This field is hidden when viewing the form

Birthdate

Month

Day

Year

(MM/DD/YYYY)

This field is hidden when viewing the form

How did you hear of this event?

This field is hidden when viewing the form

I am walking in honor/memory of

This field is hidden when viewing the form

Join Team

This field is hidden when viewing the form

Waiver*

I agree to the waiver of liability.*

Child T-shirt #10

Name*

First Last

T-Shirt Size*

This field is hidden when viewing the form

Birthdate

Month

Day

Year

(MM/DD/YYYY)

This field is hidden when viewing the form

How did you hear of this event?

This field is hidden when viewing the form

I am walking in honor/memory of

This field is hidden when viewing the form

Join Team

This field is hidden when viewing the form

Waiver*

I agree to the waiver of liability.*

Comments

This field is for validation purposes and should be left unchanged.

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