2023 Registration for 12-4-12
TO SIGN UP FOR 12-4-12 - Please place your Name, email, and phone number in the correct boxes then hit submit. You will receive a confirmation of receipt email once we receive it and verify your membership.   

Before you submit your 2023 Registration for 12-4-12, please be sure to read the Rules.  If you have any questions about the 12-4-12 Rules for 2023, please contact dqn12.4.12@gmail.com


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Is this your first year with 12-4-12 *
Required
FirstName *
LastName *
Email *

Name that you go by if different than the one posted.

Phone number to best reach you
 (formatted as XXX-XXX-XXXX)
 *
I acknowledge that I have read the 12-4-12 Rules for 2023 and agree to accept these Rules 
 *
Required
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