Hearts & Smarts Trivia Challenge

The Primary Registrant listed below should be over the age of 18. The Primary Registrant does not need to be a team member but will be the adult responsible for team payment, communications, and supervision if any team members are under the age of 14.

Teams should have at least 4 and no more than 8 people. All ages are welcome, but we recommend ages 8 and up. Please note, this is not a drop off event. Every team with a child under the age of 14, must have at least one adult in attendance. The adult does not need to be on the team.

Once your registration is complete, you will receive a link to a google form. Please complete and submit the google form NO LATER THAN MONDAY, JANUARY 20 to order your team's T-shirts.

Primary Registrant Information

First Name *

Last Name *

Email *

Mobile Phone *

Street Address (Home) *

City (Home) *

State (Home) *

Postal Code (Home) *

Team Registration Fee

Team registration is $36 per team OR $30 per team if the team includes at least one WHPS student. Please use the dropdown menu to select.

Total

Authorize.net (Credit Card)

Card Type

Card Number *

Security Code *

Expiration Date *

My billing address is the same as above

Billing Name and Address

Billing First Name *

Billing Middle Name

Billing Last Name *

Street Address *

City *

Country *

State/Province *

Postal Code *

If your team includes a WHPS student, use the box below to list

Name / School / Grade (Enter N/A if not applicable to your team) *