CME Replace the Race Name First Last Are you registering as an individual or a family?IndividualFamilyIf a family, tell us your names and ages so we can cheer you on!Email* AddressPlease enter your address if you wish to receive a receipt of your donation for tax purposes. Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Have you participated in our Father's Day Road Race before?YesNoWhat kind of activity will you be doing to help us #ReplacetheRace? Pick as many as you like. The goal is that you will commit to being active as a family. If it is fun or silly all the better!* Running Walking Skipping Jumping Rope/Jumping Jack Challenge Hiking Obstacle Coursing in the Backyard Family Olympics Family Dance Competition Family Tik Tok Dance Video Cosmic Kids Yoga Other How did you hear about our virtual #ReplacetheRace challenge?Pick your registration (donation) amount. We are grateful for your community love and support.*$15 (Thank you!)$25 (Double Thank you!)$45 (You are awesome!)$75 (Hold on a second, are you serious?)$100 (OMG!)$500 (What! Social distance hug coming at you!)$1000 (We would kiss you if we could!)Credit Card* American ExpressDiscoverMasterCardVisa Card Number Month010203040506070809101112 Year20212022202320242025202620272028202920302031203220332034203520362037203820392040 Expiration Date Security Code Cardholder Name
