2027 Black Bear Plunge

Please read and sign the Liability Waiver. Minors (under 18) must have a parent's signature to participate. Each participant you register must sign a liability waiver.

How many people are you registering? *

(including yourself)

First Name *

Last Name *

Email *

Phone *

Event Fee(s)

T-Shirt

Hoodie

Total for this participant

Credit Card

Card Type

Card Number *

Security Code *

Expiration Date *

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *