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Register for the Day One Challenge 2022
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Register for the Day One Challenge 2022
1
Your Info
2
Participants
Name
(Required)
First
Last
Address
(Required)
Address Line 1
Address Line 2
City
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
U.S. Virgin Islands
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Cell Phone
(Required)
(in case we need to reach you during the event)
Email
(Required)
(for confirmation and event instructions)
T-Shirt Size for Main Registrant
S
M
L
XL
XXL
Total Adult Participants
Please enter a number greater than or equal to
1
.
Adult Registration
Total Youth/Child Participants
Please enter a number greater than or equal to
0
.
(Participants Under 18 Years Old)
Youth/Child Registration
Additional Participant Information
Register your additional participants (beyond the main registrant entered on the previous page) by listing them below:
Name
Adult Shirt Size (S,M,L,XL,XXL)
Age (if under 18)
Add
Remove
List any special needs (ADA accessibility, allergies, etc.):
If you attend a church in the area, please list the name of the church:
How did you hear about this event?
Redemption Housing
Word of mouth
Philadelphia Reentry Coalition
My church
Other
Sign up for email updates from Redemption Housing?
Yes
No
Total Registration Fee
Comments
This field is for validation purposes and should be left unchanged.
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