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Friday, June 17 2022
Register to Rappel
Registration
Username
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First name
Last Name
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(Optional)
E-Mail
Cell Phone Number
T-Shirt Size
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Mailing Address - Street
Mailing Address - City
Mailing Address - State
--Any State--
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South Carolina
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Tennessee
Texas
Utah
Vermont
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Washington
West Virginia
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Mailing Address - Zip.
Country, if not US:
Preferred Rappel Time
I prefer to rappel in the morning
I prefer to rappel in the afternoon
Team Name
I'd like to rappel individually
I'd like to create a new team -
I'd like to join existing team -
Select a team...
Baesman Group
Boyer Family
Duc Defenders
Elevated Integrity Team
Extreme Team
Kimball Midwest Team
Leverage Opportunity
LifePoint Real Estate
New Nest Co Group Keller Williams Consultants
Orthopedic One Team
OSUPD
Roosevelt Coffeehouse Team
Team Avaap
Team Catalyst Engineering
Team Choice Recovery
Team Elife Brokerage
Team Lindsay Honda
Team Marzetti
Team Skyclimber
Team Stoltzfus
Team Treplus
Team Westoff
The Flying Olmsteads
The Naz Church
Titebond Team
Trinity Financial Team
Uniquely Unicorns
Vela Investments Team
Donation Goal Amount
Desired Site Name
Registration Fee
$100.00
Space Limited. Register Now!
Credit Card
Card Type:
Visa
Mastercard
Discover
American Express
Diner's Club
Credit Card Number:
Credit Card Expiration (mm/yy):
01
02
03
04
05
06
07
08
09
10
11
12
/
2022
2023
2024
2025
2026
2027
2028
2029
2030
2031
2032
Name On Card:
CVV Value:
Billing Address
Same as mailing address
Address:
City:
State:
--Any State--
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
D.C.
Delaware
Florida
Georgia
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
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Zip Code:
Country, if not US:
Yes, I would love to hear stories of hope and healing at Gracehaven! Please send me your monthly newsletter.
(Optional) In order to ensure my participation in Over the Edge on June 17th for Gracehaven, a division of Central Ohio Youth for Christ (COYFC), I hereby agree to allow COYFC to charge my credit card on September 18th if I am not at the fundraising minimum of $1,250.00 to guarantee my spot, the difference will be charged to my card and the maximum amount I may be charged is $1,250.00.
I hereby give permission to Central Ohio Youth for Christ (COYFC) to take event day photos of my likeness and use them in their promotional materials.
I understand that in order to rappel I will have to sign a waiver form on event day.
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