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Contact Us

 

"Empowering people with disabilities to live independently in our community."

Team Registration

Team Captains have the option of registering and paying for your partial or entire team here
Or
Register yourself as Team Captain and members of your team can register and pay at the single registration link.

Please allow 1 business day after Team Registration for the Team Captain's name to be added to this site.

If you have any questions, please click here to contact us.

Team Captain
Name*

Address*

City, State, and Zip*

Team Number*

Team Name*

Email Address*

Company

Home Phone*
Work Phone Cell Phone
T-Shirt Size*

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4450 N. Prospect Road, Suite C8, Peoria Heights, IL  61616
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