Long Island, NY Chapter

YES, I am interested in receiving information on the Crohn's & Colitis Foundation's Team Challenge program. Please contact me, I would like to learn more!

The information you enter below, is forwarded to the Long Island, NY Chapter of the Crohn's & Colitis Foundation. You will be contacted by a representative who will share all of the exciting details about Team Challenge with you.

Thank you for your interest in Team Challenge.

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First Name: Last Name: Address: City: State: Zip/Postal Code: Day Phone:  Enter a valid phone number. Example: 123-456-7890 Email:  Enter a valid email address. Example: name@company.com How did you hear about us? Please choose oneActive.com emailActive.com websiteCCFA emailCCFA e-newsletterCCFA websiteFacebookFlyer at RaceFlyer in storeFriend or family memberGymMagazinePast ParticipantRace ExpoRadioTake Steps WalkTeam Challenge emailTeam Challenge mailingTeam Challenge websiteOther If you selected, Team Challenge mailer, please enter 5 digit code (example S08FM) If you selected "other" please describe RSVP to an information meeting to learn more and join. Saturday, Sept. 4th @ 8am- "Try Us Out Training"- Eisenhower Park, Field #4 Please select the Team Challenge event you are interested in Las Vegas Rock 'n' Roll Half MarathonCycle: Centurion Canada, Sept 19, 2010Undecided