BE A PLUNGER REGISTRATION

Please fill out the form below to register as a plunger for the Lions Polar Plunge event. You must be 14 years or older to plunge. Parental consent is required for individuals under 18 years of age.

All plungers will receive a free t-shirt, food and a warm beverage of choice.

Before registering, please download and read the following waiver form. Registrants under the age of 18 MUST bring the signed waiver in order to participate.

REGISTRATION FORM

First Name
Phone Number
Last Name
Email
Member of (or plunging for)
arrow&v
Select Adult T-Shirt Size

I agree to the terms in the waiver

  • Facebook
  • Twitter
  • YouTube
  • Instagram

P.O. Box 608

Norfolk, MA 02056

Privacy Policy

©2019 This site is the property of Norfolk Lions Club - United States