2023 Moose Knuckles - Individual Registration

Team Name *

First Name *

Last Name *

Please enter the name for who will be your team captain.

City *

Province *

Cell *

Email *

T-Shirt Size *

Age *

Gender

Male

Female

Other

Number of Team Members *

Team Member 2 Name *

Team Member 2 Age *

Team Member 2 Gender *

Male

Female

Other

Team Member 2 T-Shirt Size *

Team Member 3 Name

Team Member 3 Age

Team Member 3 Gender

Male

Female

Other

Team Member 3 T-Shirt Size

Team Member 4 Name

Team Member 4 Age

Team Member 4 Gender

Male

Female

Other

Team Member 4 T-Shirt Size

Camping Available

I don't require camping

Sept 22 - $30 Serviced (Water & Power)

Sept 22 - $15 Unserviced (Tents only)

Sept 23 - $30 Serviced (Water & Power)

Sept 23 - $15 Unserviced (Tents only)

Amount

$

Tax amount

$

Gross amount

$

Payment Method

Payments via Paypal

Credit Card Number*

Expiration Date*

/

Card (CVV) Code*

Card Holder Name*

Team Member 2

Team Member 3

Team Member 4

Payment Information

Upcoming Races