QCARS 4 - Airy Forest, Cincinnati, July 27, 2019

Participant Information

Please supply the requested information about yourself. Required fields are noted with *.

*First Name:
*Last Name:
*Street Address:
Additional Address:
*Zip/Postal Code:
*Email Address:
*Confirm Email Address:
Please enter your valid email address and then enter it a second time to confirm it's accuracy. Your confirmation emails will be sent to this email address.
*Cell Phone:
Home Phone:
Please enter your cell and home telephone numbers. The cellphone number should be usable in case of emergency on the day of the event.
*Year Born:
*Primary Club:
Please select your primary club. If your club is not listed, select "Other" and enter your club name in the notes field (next page).
*Federation Membership:
*OUSA Member ID:
Please select your national federation membership
*E-Punch Number:
*Will Rent E-Punch:
($0.00 per event)
Please enter your E-Punch number or check the box if you plan to rent an e-punch for the event. If you will not be competing in any races please enter 0 (zero) as your E-Punch number.