Step 2 of 4 (Registration Form)

2025 EPBC POLAR ICE PLUNGE
Donation Only

Wednesday, January 1, 2025 in East Peoria, IL at East Peoria Boat Club

Please enter your registration information in the form below. When you are finished, click the "Proceed to Confirmation Page" button to continue. Required fields are marked with a *.

Select Your Team

This is a group registration category. If you do not see your group listed, your team leader has not registered. If you are the team leader, click here to create a team.

  • Off In Church (139343000002)
  • Team - Cam Junker (13934300001)

Personal Information

Please enter the requested information about you (or the person for whom you are registering). Be sure the contact details are correct so that we can provide important, registration-related information.

  • male
  • female
:
  • January
  • February
  • March
  • April
  • May
  • June
  • July
  • August
  • September
  • October
  • November
  • December
  • 1
  • 2
  • 3
  • 4
  • 5
  • 6
  • 7
  • 8
  • 9
  • 10
  • 11
  • 12
  • 13
  • 14
  • 15
  • 16
  • 17
  • 18
  • 19
  • 20
  • 21
  • 22
  • 23
  • 24
  • 25
  • 26
  • 27
  • 28
  • 29
  • 30
  • 31
  • 2024
  • 2023
  • 2022
  • 2021
  • 2020
  • 2019
  • 2018
  • 2017
  • 2016
  • 2015
  • 2014
  • 2013
  • 2012
  • 2011
  • 2010
  • 2009
  • 2008
  • 2007
  • 2006
  • 2005
  • 2004
  • 2003
  • 2002
  • 2001
  • 2000
  • 1999
  • 1998
  • 1997
  • 1996
  • 1995
  • 1994
  • 1993
  • 1992
  • 1991
  • 1990
  • 1989
  • 1988
  • 1987
  • 1986
  • 1985
  • 1984
  • 1983
  • 1982
  • 1981
  • 1980
  • 1979
  • 1978
  • 1977
  • 1976
  • 1975
  • 1974
  • 1973
  • 1972
  • 1971
  • 1970
  • 1969
  • 1968
  • 1967
  • 1966
  • 1965
  • 1964
  • 1963
  • 1962
  • 1961
  • 1960
  • 1959
  • 1958
  • 1957
  • 1956
  • 1955
  • 1954
  • 1953
  • 1952
  • 1951
  • 1950
  • 1949
  • 1948
  • 1947
  • 1946
  • 1945
  • 1944
  • 1943
  • 1942
  • 1941
  • 1940
  • 1939
  • 1938
  • 1937
  • 1936
  • 1935
  • 1934
  • 1933
  • 1932
  • 1931
  • 1930
  • 1929
  • 1928
  • 1927
  • 1926
  • 1925
  • 1924
  • 1923
  • 1922
  • 1921
  • 1920
  • 1919
  • 1918
  • 1917
  • 1916
  • 1915
  • 1914
  • 1913
  • 1912
  • 1911
  • 1910
  • 1909
  • 1908
  • 1907
  • 1906
  • 1905
  • 1904

Address Information

  • Afghanistan
  • Albania
  • Algeria
  • American Samoa
  • Andorra
  • Angola
  • Anguilla
  • Antarctica
  • Antigua and Barbuda
  • Argentina
  • Armenia
  • Aruba
  • Australia
  • Austria
  • Azerbaijan
  • Bahamas
  • Bahrain
  • Bangladesh
  • Barbados
  • Belarus
  • Belgium
  • Belize
  • Benin
  • Bermuda
  • Bhutan
  • Bolivia
  • Bosnia and Herzegovina
  • Botswana
  • Bouvet Island
  • Brazil
  • British Indian Ocean Territory
  • Brunei Darussalam
  • Bulgaria
  • Burkina Faso
  • Burundi
  • Cambodia
  • Cameroon
  • Canada
  • Cape Verde
  • Cayman Islands
  • Central African Republic
  • Chad
  • Chile
  • China
  • Christmas Island
  • Cocos (keeling) Islands
  • Colombia
  • Comoros
  • Congo
  • Congo, The Democratic Republic Of The
  • Cook Islands
  • Costa Rica
  • Cote d'Ivoire
  • Croatia
  • Cuba
  • Curacao
  • Cyprus
  • Czech Republic
  • Denmark
  • Djibouti
  • Dominica
  • Dominican Republic
  • Ecuador
  • Egypt
  • El Salvador
  • Equatorial Guinea
  • Eritrea
  • Estonia
  • Ethiopia
  • Falkland Islands (malvinas)
  • Faroe Islands
  • Fiji
  • Finland
  • France
  • French Guiana
  • French Polynesia
  • French Southern Territories
  • Gabon
  • Gambia
  • Georgia
  • Germany
  • Ghana
  • Gibraltar
  • Greece
  • Greenland
  • Grenada
  • Guadeloupe
  • Guam
  • Guatemala
  • Guinea
  • Guinea-bissau
  • Guyana
  • Haiti
  • Heard Island and Mcdonald Islands
  • Holy See (vatican City State)
  • Honduras
  • Hong Kong
  • Hungary
  • Iceland
  • India
  • Indonesia
  • Iran, Islamic Republic Of
  • Iraq
  • Ireland
  • Israel
  • Italy
  • Jamaica
  • Japan
  • Jordan
  • Kazakhstan
  • Kenya
  • Kiribati
  • Korea, Democratic People's Republic Of
  • Korea, Republic Of
  • Kuwait
  • Kyrgyzstan
  • Lao People's Democratic Republic
  • Latvia
  • Lebanon
  • Lesotho
  • Liberia
  • Libyan Arab Jamahiriya
  • Liechtenstein
  • Lithuania
  • Luxembourg
  • Macao
  • Macedonia, The Former Yugoslav Republic Of
  • Madagascar
  • Malawi
  • Malaysia
  • Maldives
  • Mali
  • Malta
  • Marshall Islands
  • Martinique
  • Mauritania
  • Mauritius
  • Mayotte
  • Mexico
  • Micronesia, Federated States Of
  • Moldova, Republic Of
  • Monaco
  • Mongolia
  • Montserrat
  • Morocco
  • Mozambique
  • Myanmar
  • Namibia
  • Nauru
  • Nepal
  • Netherlands
  • Netherlands Antilles
  • New Caledonia
  • New Zealand
  • Nicaragua
  • Niger
  • Nigeria
  • Niue
  • Norfolk Island
  • Northern Mariana Islands
  • Norway
  • Oman
  • Pakistan
  • Palau
  • Palestinian Territory, Occupied
  • Panama
  • Papua New Guinea
  • Paraguay
  • Peru
  • Philippines
  • Pitcairn
  • Poland
  • Portugal
  • Puerto Rico
  • Qatar
  • Reunion
  • Romania
  • Russian Federation
  • Rwanda
  • Saint Helena
  • Saint Kitts and Nevis
  • Saint Lucia
  • Saint Pierre and Miquelon
  • Saint Vincent and The Grenadines
  • Samoa
  • San Marino
  • Sao Tome and Principe
  • Saudi Arabia
  • Senegal
  • Serbia and Montenegro
  • Seychelles
  • Sierra Leone
  • Singapore
  • Slovakia
  • Slovenia
  • Solomon Islands
  • Somalia
  • South Africa
  • South Georgia and The South Sandwich Islands
  • Spain
  • Sri Lanka
  • Sudan
  • Suriname
  • Svalbard and Jan Mayen
  • Swaziland
  • Sweden
  • Switzerland
  • Syrian Arab Republic
  • Taiwan
  • Tajikistan
  • Tanzania, United Republic Of
  • Thailand
  • Timor-Leste
  • Togo
  • Tokelau
  • Tonga
  • Trinidad and Tobago
  • Tunisia
  • Turkey
  • Turkmenistan
  • Turks and Caicos Islands
  • Tuvalu
  • Uganda
  • Ukraine
  • United Arab Emirates
  • United Kingdom
  • United States
  • United States Minor Outlying Islands
  • Uruguay
  • Uzbekistan
  • Vanuatu
  • Venezuela
  • Viet Nam
  • Virgin Islands, British
  • Virgin Islands, U.s.
  • Wallis and Futuna
  • Western Sahara
  • Yemen
  • Zambia
  • Zimbabwe
  • Alabama
  • Alaska
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • District of Columbia
  • Delaware
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Puerto Rico
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
  • Armed Forces - America
  • Armed Forces - Europe
  • Armed Forces - Pacific

Contact Information

Questions & Add ons

Have you participated in the Polar Plunge before?



* Thank you for your generous donation!

Special offer from ROAD iD

Your registration qualifies you for a FREE $10 ROAD iD Gift Card!
A gift from us to keep you safe.

The one piece of gear no athlete should be without. Looks great, lasts forever, and just might save your life.



Payment Information

Please enter your billing information. The credit card type will be determined automatically. Your information will be processed over a secure, encrypted connection. Once you have finished registering, GetMeRegistered.com will not store your credit card details.

  • 01
  • 02
  • 03
  • 04
  • 05
  • 06
  • 07
  • 08
  • 09
  • 10
  • 11
  • 12
  • 2024
  • 2025
  • 2026
  • 2027
  • 2028
  • 2029
  • 2030
  • 2031
  • 2032
  • 2033
  • 2034
  • 2035
  • 2036
  • 2037
  • 2038
  • 2039
  • Afghanistan
  • Albania
  • Algeria
  • American Samoa
  • Andorra
  • Angola
  • Anguilla
  • Antarctica
  • Antigua and Barbuda
  • Argentina
  • Armenia
  • Aruba
  • Australia
  • Austria
  • Azerbaijan
  • Bahamas
  • Bahrain
  • Bangladesh
  • Barbados
  • Belarus
  • Belgium
  • Belize
  • Benin
  • Bermuda
  • Bhutan
  • Bolivia
  • Bosnia and Herzegovina
  • Botswana
  • Bouvet Island
  • Brazil
  • British Indian Ocean Territory
  • Brunei Darussalam
  • Bulgaria
  • Burkina Faso
  • Burundi
  • Cambodia
  • Cameroon
  • Canada
  • Cape Verde
  • Cayman Islands
  • Central African Republic
  • Chad
  • Chile
  • China
  • Christmas Island
  • Cocos (keeling) Islands
  • Colombia
  • Comoros
  • Congo
  • Congo, The Democratic Republic Of The
  • Cook Islands
  • Costa Rica
  • Cote d'Ivoire
  • Croatia
  • Cuba
  • Curacao
  • Cyprus
  • Czech Republic
  • Denmark
  • Djibouti
  • Dominica
  • Dominican Republic
  • Ecuador
  • Egypt
  • El Salvador
  • Equatorial Guinea
  • Eritrea
  • Estonia
  • Ethiopia
  • Falkland Islands (malvinas)
  • Faroe Islands
  • Fiji
  • Finland
  • France
  • French Guiana
  • French Polynesia
  • French Southern Territories
  • Gabon
  • Gambia
  • Georgia
  • Germany
  • Ghana
  • Gibraltar
  • Greece
  • Greenland
  • Grenada
  • Guadeloupe
  • Guam
  • Guatemala
  • Guinea
  • Guinea-bissau
  • Guyana
  • Haiti
  • Heard Island and Mcdonald Islands
  • Holy See (vatican City State)
  • Honduras
  • Hong Kong
  • Hungary
  • Iceland
  • India
  • Indonesia
  • Iran, Islamic Republic Of
  • Iraq
  • Ireland
  • Israel
  • Italy
  • Jamaica
  • Japan
  • Jordan
  • Kazakhstan
  • Kenya
  • Kiribati
  • Korea, Democratic People's Republic Of
  • Korea, Republic Of
  • Kuwait
  • Kyrgyzstan
  • Lao People's Democratic Republic
  • Latvia
  • Lebanon
  • Lesotho
  • Liberia
  • Libyan Arab Jamahiriya
  • Liechtenstein
  • Lithuania
  • Luxembourg
  • Macao
  • Macedonia, The Former Yugoslav Republic Of
  • Madagascar
  • Malawi
  • Malaysia
  • Maldives
  • Mali
  • Malta
  • Marshall Islands
  • Martinique
  • Mauritania
  • Mauritius
  • Mayotte
  • Mexico
  • Micronesia, Federated States Of
  • Moldova, Republic Of
  • Monaco
  • Mongolia
  • Montserrat
  • Morocco
  • Mozambique
  • Myanmar
  • Namibia
  • Nauru
  • Nepal
  • Netherlands
  • Netherlands Antilles
  • New Caledonia
  • New Zealand
  • Nicaragua
  • Niger
  • Nigeria
  • Niue
  • Norfolk Island
  • Northern Mariana Islands
  • Norway
  • Oman
  • Pakistan
  • Palau
  • Palestinian Territory, Occupied
  • Panama
  • Papua New Guinea
  • Paraguay
  • Peru
  • Philippines
  • Pitcairn
  • Poland
  • Portugal
  • Puerto Rico
  • Qatar
  • Reunion
  • Romania
  • Russian Federation
  • Rwanda
  • Saint Helena
  • Saint Kitts and Nevis
  • Saint Lucia
  • Saint Pierre and Miquelon
  • Saint Vincent and The Grenadines
  • Samoa
  • San Marino
  • Sao Tome and Principe
  • Saudi Arabia
  • Senegal
  • Serbia and Montenegro
  • Seychelles
  • Sierra Leone
  • Singapore
  • Slovakia
  • Slovenia
  • Solomon Islands
  • Somalia
  • South Africa
  • South Georgia and The South Sandwich Islands
  • Spain
  • Sri Lanka
  • Sudan
  • Suriname
  • Svalbard and Jan Mayen
  • Swaziland
  • Sweden
  • Switzerland
  • Syrian Arab Republic
  • Taiwan
  • Tajikistan
  • Tanzania, United Republic Of
  • Thailand
  • Timor-Leste
  • Togo
  • Tokelau
  • Tonga
  • Trinidad and Tobago
  • Tunisia
  • Turkey
  • Turkmenistan
  • Turks and Caicos Islands
  • Tuvalu
  • Uganda
  • Ukraine
  • United Arab Emirates
  • United Kingdom
  • United States
  • United States Minor Outlying Islands
  • Uruguay
  • Uzbekistan
  • Vanuatu
  • Venezuela
  • Viet Nam
  • Virgin Islands, British
  • Virgin Islands, U.s.
  • Wallis and Futuna
  • Western Sahara
  • Yemen
  • Zambia
  • Zimbabwe
  • Alabama
  • Alaska
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • District of Columbia
  • Delaware
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Pennsylvania
  • Puerto Rico
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
  • Armed Forces - America
  • Armed Forces - Europe
  • Armed Forces - Pacific





GetMeRegistered logo