step 1 of 2 (team setup form)

2025 EPBC POLAR ICE PLUNGE

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

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

Team Information

The information you enter here is what people will see when they are looking for your team. Be sure to provide recognizable information.

team name: *

Leader's Contact Information

Please enter your contact information in the form below. If you wish to participate as well, you will need to register separately.

first name: *
last name: *
address: *
city, state: *	,
postal code: *
country:
email address: *
notices:	I would like to be notified when someone registers for my team.
primary phone:
secondary phone:

Account Information

In order to administer your team homepage, you need a GetMeRegistered.com account. Please choose a username and password below.

desired username:
desired password:
reenter password:

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