goPINK Fun Run/Walk

Donate - goPINK Logo + Collage

2019 Registration Form

Event Details

  • Date: Sunday, September 22nd
  • Time: 9 am - 11 am | Registration begins at 8:30 am
  • Location: Middletown High School | 200 LaRosa Lane | Middletown, CT

Registration Instructions

  • To Register as an Individual: Simply complete the form below! If you are representing a local business, you may include its name in the "Team or Company Name" field.

  • To Create a Team: To start a team, simply complete the form below, and be sure to include a team name in the "Team or Company Name" field. You may register as many team members as you would like. However, when you register for multiple team members, you must also pay for those team members.

  • To Join a Team: To join an existing team, simply complete the form below. Be sure to include the name of the team you are joining in the "Team or Company Name" field. If you do not know the team name, please put the name of the main contact for your team (likely the person who created your team or registered first).

  • As a Spectator: We ask that all attendees at the event—including spectators—pay the donation for entry. Spectators can register online using this form ($10) or pay $15 at the door.

If you have questions about how to register, please contact Kathleen Russo at 860-358-6200 or kathleen.russo@midhosp.org.

2019 Tug-O-War Challenge

This year's Fun Run/Walk will feature a Tug-O-War Challenge! Click here to learn more and register your team.

Become a Sponsor

Lend your support as a 2019 goPINK Fun Run/Walk sponsor! Click here to submit a sponsorship—whether monetary, in-kind, or as prizes!

More About goPINK

Visit the goPINK homepage to learn more.

All fields are required unless otherwise noted.

Main Contact

This is the person who will be the main contact for any notices or information we need to send out. This does not have to be the same as the billing contact nor does this person have to attend.

First name is required
Last name is required
Email is required
Phone is required
Team/Company Name is required
If you are starting a team or are representing a local business, please indicate the name here. If you are joining a team, please type the name of your team OR the main contact for your team.

Registration

Must be an integer

Team Members

Billing Information

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A confirmation email will be sent to this email address.

Payment Details

Accepted cards
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mm/yyyy
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Card Verification Value (CVV)