Register


The event will follow CDC Guidelines and be subject to the Village of Lincolnwood Covid-19 Regulations.
Registration Information
First Name: *
Last Name: *
Address: *
City: *
State: *
Zip / Postal: *
Country: *
Phone Number: *
Additional Phone Number:
Email Address: *
Date of Birth: *
Jersey Size: *
name on back of jersey: *
jersey number: *
Emergency Contact Information
Emergency Contact: *
Emergency Phone: *
Fundraising Commitment


Account Information
Custom URL:* Create your custom url to use for your personal fundraising page (This will also be your account username)
https://www.rayze.it/madraigosmidwest/
Sign in with Google or choose a password. You will need it to view / edit your personal web page, and see who has sponsored you for this event.
Sign in with Google
OR
Password: *
Re-Type Password: *
Payment Details
You will be charged a $100 non-refundable registration fee.
Card Type: *
Card Number: *
Exp. Month: *
Exp. Year: *
Security Code: *
Additional Information optional
Additional Comments:
How Did You Hear About Us?

Only enter this field if you were told to do so by a staff member.


Madrigos Midwest is a non-profit 501c3 organization.