Participant Registration

Choose from one of the following options to continue registering:

I AM A NEW
PARTICIPANT

Participant First Name:*

Participant Last Name:*

Participant Email:*

Confirm Email:*

By registering as a participant and providing your email address, you are agreeing to receive important participant event updates via email.

User Name:*

A user name and password must be entered in order to be able to access and update your personal fundraising page.
Enter a unique user name for each participant of the event. No spaces allowed.
(i.e. first and last name: janedoe or first initial and last name jdoe)

Password:*

Minimum 6 characters. At least one letter and one number.
Only enter letters, numbers, periods, hyphens or exclamation marks.

Confirm Password:*

I would like to set a goal of:*

CLICK BELOW TO SELECT A FUNDRAISING GOAL. You can participate and also setup a personal fundraising page to help raise extra funds for programs that assist Neuroendocrine and Carcinoid Cancer (NET) patients, such as our NET Cancer Hotline, Patient Conferences, and educational webinars.
This goal is not a commitment, but rather what Neuroendocrine Cancer Awareness Network hopes you will be able to raise for our cause.

In addition to registering, I would like to make a donation in the amount of:

$.00

What Shirt Size Would You Like?:*

Small
Medium
Large
X Large
XX Large
XXX Large

Enter shipping address if different from mailing address::

Waiver and Release
In consideration of this entry being accepted, I hereby for myself, heirs, executors, and administrators, waive and release any claim I may have against Neuroendocrine Cancer Awareness Network, its officers and directors, the organizing committee, the sponsoring organizations, Park Road Park and Mecklenburg County, NC or their representatives, successors, or assignees for any injury that may be suffered by me at or in this event. I attest that I (my child) am (is) physically able and prepared for this event. I grant full permission to organizers to use photographs and videography of me (my child) and quotations from me (my child) in legitimate accounts and promotions for this event. I understand that children under 13 must walk with an adult. I have read this release and certify my agreement by continuing the registration process.:*
I Agree