Register for the Safelite Challenge
* indicates a required field


Participant details
















Emergency Contact





Event details

Please note, our teams will follow up with you to complete your equipment requests, hotel reservations and transportation details. For now, please select which option best fits your needs.

Please note, you are responsible for booking your own flights. The Safelite team will need your flight information to make sure we have transportation available for you from the Airport to the Hotel.










*Team



*Participant activity

What activity? Check all that apply.


Fundraising


$1000 (Full Package) commits you to a $1000 fundraising goal and allows you to have your own hotel room (if you elect to bring a guest, there may be additional charges to participate in an event on Saturday and to attend the evening celebrations).
$500 (Shared Package) commits you to a $500 fundraising goal and requires that you share your hotel room (you may select your roommate below otherwise one may be selected for you).

$25


*Fundraising Team



Event questions







Hotel & Transportation






Billing Information







Your credit card will not be charged at this time and will only be used to satisfy any outstanding amount for your fundraising commitment on or after May 31, 2019. You will be notified prior to any charge.





Create your account

Create your user name and password to access and manage your Safelite Challenge account.





Agreements



By submitting the registration I am committing to the minimum fundraising amount in my package. All funds must be raised by May 31, 2019.


Please correct the highlighted fields.


CCV explanation This code is the 3 digit number on the back of your credit card, usually next to your signature.