Team Registration
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Below is the 2012 Team Registration form for the 8th Annual Polar Plunge. The team captain should fill the form out and list all team members and their shirt sizes. If you need to enter more member at a later date,  just submit another form with the team name, and your email address entered. All team members must sign and date a plunge wavier form prior to the plunge. These forms can be print by using the following link, 2012 WAIVER Form. Waiver form can also be picked up at the registration desk.

teamregistration

Team Captain, please fill in the information for your team.

Team Name  

First Name       Last Name 

Address       

City                        State            Zip  

Phone                E-Mail  

Shirt Size                    Pledge Amount    

The minimum per non-school teams is $50.00 per team member, $30.00 for students.

This is a School Team   School Name  

List Team Members Below. Minimum age to plunge is 8 years.

Name       Shirt Size:   

Name       Shirt Size:   

Name       Shirt Size:  

Name      Shirt Size:  

Name      Shirt Size:  

Name      Shirt Size:  

Name      Shirt Size:  

Name      Shirt Size:  

Name      Shirt Size:  

Name      Shirt Size:  

Name      Shirt Size:  

Name      Shirt Size:  

Name      Shirt Size:  

Name      Shirt Size:  

Name      Shirt Size:  

 

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