Please fill out the following form completely. This event is open to only 15 pairs and it is first come first served. Your registration will not be complete until you have paid the associated fee, $20 for members/$30 for non-members. Once you have completed your registration and paid the event fee, you will be notified of your spot in the event. Thank you for your interest and we're looking forward to having a great time with you and the special lady in your life!

All information collected is for administrative use and will be kept in confidence. No information will be shared with parties outside of Heirloom Athletics.