1 Million 4 Anna Foundation · 2019 Piper's Legacy Rock the Challenge

To continue registering for this event, parents/guardians must agree to the Rock the Challenge participant waiver.

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I agree to the above waiver.

Registration is $25/kid ninja (Choose the number of kids under quantity) *	Quantity
$25

Additional donation to Piper's Legacy

$

Kid Ninja #1 Name

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First Name

Last Name

Kid Ninja #1 Heat Time

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Limit of 60 per heat

Kid Ninja #2 Name

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First Name

Last Name

Kid Ninja #2 Heat Time

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Limit of 60 per heat

Kid Ninja #3 Name

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First Name

Last Name

Kid Ninja #3 Heat Time

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Limit of 60 per heat

Kid Ninja #4 Name

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First Name

Last Name

Kid Ninja #4 Heat Time

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Limit of 60 per heat

Kid Ninja #5 Name

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First Name

Last Name

Kid Ninja #5 Heat Time

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Limit of 60 per heat

Parent Information

Parent's Name

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First Name

Last Name

Parent's Email

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Verify Email

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Parent's Phone

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Address

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Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

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Parent Information