Registration

Username

Password

First name

Last Name

E-Mail

Cell Phone Number

T-Shirt Size

Mailing Address - Street

Mailing Address - City

Mailing Address - State

Mailing Address - Zip.

Country, if not US:

Rappel Options

Preferred Rappel Time

While we will do our best to accomodate your request, rappel times are subject to change.

Registration Type

	Individual:	I pledge to raise $1,000.00
Catch your breath, step up to the edge and rappel 8 stories down the International Motorsports Center. The first 200 fundraisers to raise a minimum of $1,000 will earn a spot to go Over The Edge At ONE DAYTONA. Download Flyer
	Go Pro:	I pledge to raise $2,000.00
Catch your breath, step up to the edge and rappel over 100 feet down the International Motorsports Center. The fundraisers who raise a minimum of $2,000 will earn a spot to go Over The Edge At ONE DAYTONA with a go pro.
	Toss the Boss:	I pledge to raise $2,500.00	and toss at
Have you ever wanted to tell your boss to take a leap? “Toss your Boss” for charity - gather your coworkers and raise a minimum of $2,500 to send your boss rappelling over 100 feet down the International Motorsports Center. Download Flyer
	Toss Your Favorite Mascot:	I pledge to raise $2,500.00	and toss at
Have you ever wanted to see your favorite mascot rappel 8 stories down the International Motorsports Center? Teams that raise a minimum of 2,500 can send their favorite mascot Over The Edge. Download Flyer
	Catch the Coach:	I pledge to raise $2,500.00	and toss at
Have you ever wanted to tell your coach to take a leap? “Catch Your Coach” for charity - gather your teammates and raise a minimum of $2,500 to send your coach rappelling 8 stories down the International Motorsports Center. Download Flyer
	I'd like to create a new team -		and I pledge to raise $1000
	I'd like to join existing team -		and I pledge to raise $1000

Personal fundraising page

Desired Site Name

Registration Fee

$25.00

Credit Card

Card Type:

Credit Card Number:

Credit Card Expiration (mm/yy):

Name On Card:

CVV Value:

Billing Address

Address:

City:

State:

Zip Code:

Country, if not US:

Terms of Registration

I understand that $1,000 is the minimum fundraising necessary to Rappel.
By checking this box, I authorize the Nascar Foundation and Easter Seals to charge my credit card ( entered above ) for the balance remaining.

Any questions or ideas for alternate options for fundraising, please email email here

Please note: we are not able to issue refunds for registration fees or donations

Be Brave for Courageous Kids!

Thursday, November 16 - Saturday, November 18