For your convenience, if your browser supports forms, you may submit this on-line registration form by filling out the information and clicking below. Click here for more information about Corporate Cup 2K Fun Walk.
 

If you are already registered through the full Corporate Cup Registration, use this form to submit your roster or additional teams. You may also use this form to register for this event if you have not registered for the full Corporate Cup package. 

Registration Form:
This is:
the Walk entry part of a full Corporate Cup registration
an individual Walk event entry

Team Name:  
Organization:  
Address 1:  
Address 2:  
City:  State:   Zip:  


Contact Person:
Name:  
Work Phone:   Home Phone:  

E-mail Address:  

Please use the space below to fill in the names of your walkers. Signatures will be required on the day of competition. 

 
 

Entrance Fees The Walk entrance fee is $25 per team (Any number of participants). Simply complete this form and submit it for each additional team. Payment is due at the Y before the event. Please mail to: Valley YMCA 12 State Street Ansonia, CT 06401 If you took advantage of the full Corporate Cup registration, your first team is covered in the registration fee.

   

You will be contacted within 48 hours to confirm your registration.