Register Your Star for our 2026 Event

Participants First Name

Participants Last Name

Participants Birthday

Month

Day

Year

Participant Pant Size

Participant Diagnosis (if any)

Is there anything specific we need to know about participants diagnosis? Any Special Instructions?

Will participant be using any special equipment to assist with mobility during the event? If so, please list and explain:

Does participant require assistance with anything specific? If so, please explain:

Does participant have a specific helper that they would like to volunteer to help them during the event? If so, please provide their name and contact information:

Tell us about your star! Mention their: Age, grade, things that make them happy, hobbies/interests, etc.

Parent or Guardian First Name

Parent or Guardian Last Name

Phone

Email

Home Address (for our mailing list)

Anything else you'd like to tell us? Do you have any questions you'd like us to contact you about?

Please upload an image of your participant

I understand that by signing this form, I am authorizing MissionIsPossible to use this information and my participant's uploaded image on the website for fundraising, promoting the event, and also during the event itself.

I agree

Parent or Guardian Signature

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