LIVESTRONG Day 2008 Registration

Please note: If you are a 2008 LIVESTRONG Challenge, World Marathon Major (Boston, London, Berlin, Chicago, or NYC), RAGBRAI, or Grassroots Fundraising participant, please register your event but DO NOT check the box to sign up to fundraise. Instead, please use your existing fundraising account for your LIVESTRONG Day event. Thank you!

Already Registered? Click here to autofill this form

* required information   First Name:* Last Name:* Birth Date:* (mm/dd/yyyy) Gender: Female   Male   Email:* Phone:* Organization/Company Name: Address Line 1:* Address Line 2: City:* State:* -- please make a selection --AlabamaAlaskaAmerican SamoaArizonaArkansasArmed Forces AmericasArmed Forces EuropeArmed Forces PacificCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaF.S. MicronesiaFloridaGeorgiaGuam HawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarshall IslandsMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPalauPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirgin IslandsVirginiaWashingtonWest VirginiaWisconsinWyomingNot in USA ZIP/Postal Code:* Province: Country: -- please make a selection --AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo, The Democratic RepublicCook IslandsCosta RicaCote d'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran, Islamic Republic ofIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyan Arab JamahiriyaLiechtensteinLithuaniaLuxembourgMacaoMacedonia, The Former Yugoslav Republic ofMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia, Federated States ofMoldova, Republic ofMonacoMongoliaMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorthern Mariana IslandsNorwayOmanPakistanPalauPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarReunionRomaniaRussian FederationRwandaSaint HelenaSaint Kitts and NevisSaint LuciaSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania, United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUnited States Minor Outlying IslandsUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, USWallis and FutunaWestern SaharaYemenZambiaZimbabwe Please select the racial and ethnic category or categories with which you most closely identify. Select all that apply:* African-American/Black American Indian/Alaska Native Asian Caucasian/White Hispanic or Latino Native Hawaiian or Other Pacific Islander Other I prefer not to respond Why is raising awareness about the issues faced by cancer survivors important to you?:* Are you a registered voter?:* Yes No Please briefly describe any experience you have had working/volunteering in the cancer community:* Have you ever taken part in any of the following: Organizing events Writing letters to elected officials or media representatives Face-to-face meetings with elected officials Fundraising Speaking publicly to others about cancer issues Public speaking about other topics Event Name:* Is your event open to the general public?:* Yes No Event Description:* I plan to fundraise:* Yes No Event Location (ie: name of park, school, business, etc.):* Event Address:* Event City:* Event State:* -- please make a selection -- AL AK AS AZ AR CA CO CT DE DC FM FL GA GU HI ID IL IN IA KS KY LA ME MH MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND MP OH OK OR PW PA PR RI SC SD TN TX UT VT VA VI WA WV WI WY Not in USA Event Zip Code: Event Date:* (mm/dd/yyyy) Event Start Time:* Event End Time:* Event Website: Audience for event (include anticipated number of attendees/participants):* Describe publicity/promotional plans for this event:* I agree to the terms defined in the waiver:* Yes Create Username and Password Username:* Password:* Verify password:* Security Question: What is your mother's maiden nameWhat is your favorite restaurantWhat is your favorite sports teamWho was your childhood heroWho is your favorite celebrity of all time Security Answer:* Subscribe to our eNewsletters! 2008 LIVESTRONG Newsletter Advocacy Newsletter Type the characters you see in the picture below:*   By submitting this registration form, I agree that the Lance Armstrong Foundation may post my name, email address, event location zip code, and event name and description on livestrong.org, and do not hold the Lance Armstrong Foundation liable for the distribution of this information.