Tupper Lake Winter Triad Registration

Entrant Information

This information will be publicly visible.

Name
City, State/Country

If you live outside of the United States and Canada, please enter your country rather than state or province. e.g. "Montreal, Canada" or "Paris, France". Leave this field blank if you do not wish to share your location on the roster.
Group

Use this field for group hikes such as school classes or summer camps.

Enter the date you completed each hike.

If your browser does not support the calendar popup, please enter your dates in YYYY-MM-DD format. e.g. 2025-01-01
Coney Mt
Goodman Mt
Mt Arab

Contact/Payment Information

Contact/Billing Information

Email

Enter your payment information

The registration fee is $8.00 USD. Patches may take up to 3 weeks to arrive.
Name on Card
Card Number
MM / YY

/

CSC

Billing Address

Use the mailing address for the billing address
Enter your billing address

Use this autocomplete field to autofill your billing address information.
Street Address
City
State
Postal Code
Country

Mailing Address

Enter your mailing address

Use this autocomplete field to autofill your mailing address information.
Street Address
City
State
Postal Code
Country

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