If you are registering as an individual and will not be crowd-funding, please fill out this entire form before Monday, January 22. If you would like to crowd-fund as an individual, please contact Jessie at jessie@wellspringmultiservice.org.

INDIVIDUAL REGISTRATION ONLY INCLUDES THE PLUNGE AND NO OTHER TEAM-BASED WINTER WARRIOR GAMES. DO NOT REGISTER MORE THAN ONE PERSON USING THIS FORM AND UNDER QUANTITY ONLY SELECT “1”.