CleftStrong Free Entry Request

With great thanks to sponsors who wish to sponsor participants for the annual CleftStrong 5k and Kids Fun Run event, we are able to provide a CleftStrong free entry for those interested through September 17, 2020! Please submit this request form and upon availability, we will email your free entry promo code to use at registration.

CleftStrong Free Entry Request

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Name of person completing this form *

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Address *

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Email for the person completing this form *

Free Participant's First and Last Name *

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Please list your Cleft & Craniofacial Clinic/Hospital Here *

Cleft & Craniofacial Clinic/Hospital Phone Number *

Hospital Name and Address *

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Please list your Craniofacial Center Director's Name Here *

Please describe your cleft/craniofacial condition *

A great reason for this event is to share awareness and understanding with the public about cleft/craniofacial conditions. Would you like more information on the opportunity to share some of your journey during opening or closing ceremony? (We provide suggestions on sharing for those interested.) *

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Please confirm: *

I am a cleft/craniofacial patient. Upon availability, please email my free entry promo code to the email address above. I understand that I must register as a 5k, fun run, or virtual race participant using the promo code I am provided by the September 17, 2020 registration deadline in order to receive all race packet items listed with my free entry.

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