MyEventRunner - Event Public Fill

Optional: Do you have a ClubRunner login?

User Name:

Password:

Your Information

If you are not a Rotarian, please complete your name and email address in the boxes below:

First Name:

Last Name:

Badge Name (First name or Nickname):

Email:

Club Name:

Preferred Phone:

If you are a member of Rotaract, what is the name of your club?:

If you are a member of Interact, what is your club name?:

I consent to the collection, storage, and use of my information by Rotary District 5500 as described in this Privacy Policy. I understand that I may receive emails regarding this event and other relevant information, and can opt out at any time. Required

Your Partner/Guest Information

If you are not a Rotarian, please complete your name and email address in the boxes below:

First Name:

Last Name:

Badge Name (First name or Nickname):

Email:

Club Name:

Preferred Phone:

If you are a member of Rotaract, what is the name of your club?:

If you are a member of Interact, what is your club name?:

I consent to the collection, storage, and use of my information by Rotary District 5500 as described in this Privacy Policy. I understand that I may receive emails regarding this event and other relevant information, and can opt out at any time.

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