LHS Pikes Peak2010

Pikes Peak Rocks 2010

Thank you for your interest in Pikes Peak Rocks 2010. Submission of this application does not confirm your participation in Pikes Peak Rocks 2010 until your $79 registration payment has been received. After submitting this form you will be brought to the payment page whereupon you may remit payment and confirm your spot. All fields are required. Spots are limited.

Step 1: Complete registration form
Step 2: Remit your $79 registration fee
Step 3: create your personal hiker page

ALL fields are required!
First Name:
Last Name:
Nickname
Address:
City:
State:
Zip:
Country:
Phone:
Email:
Date of Birth:
Please select one of the following participation options.	1. Pikes Peak hike only. $79 registration fee. No minimum donation required. 2. Pikes Peak hike, Red Rocks Post Party and Party Bus. $79 registration fee and $750 fundraising pledge. 3. Red Rocks Party only. Party bus NOT included. $79 registration fee. $300 fundraising pledge.
How did you hear about "Pikes Peak 2010"?:
Are you aware of the physical activity required?	yes no
Are you physically capable of completing this hike?	yes no
Have you climbed any other mountains?	yes no
Additional Comments:
Shirt Size:	please specify mens or womens size
Shoe Size:
Validation Code:	(cAse SeNSItivE!)