First name
Last Name
Cell Phone Number
T-Shirt Size
Mailing Address - Street
Mailing Address - City
Mailing Address - State
Mailing Address - Zip.
Country, if not US:
Preferred Rappel Time
We will do our best to honor your time request but we reserve the right to make adjustments of the time that you will be rappelling.
Team Name
For every $1,000 raised by the team, 1 team member will rappell.
I'd like to rappel individually

I'd like to create a new team -
I'd like to join existing team -
Donation Goal Amount
Desired Site Name

Registration Fee
$25 till July 15th
$50 till event day

The registration fee will go towards your total and it is nonrefundable
(Optional) In order to ensure my participation in Over the Edge and to to guarantee my spot, I hereby agree to allow United Way of the Brazos Valley to charge my credit on September 7th for the amount of $1,000 less the amount of funds I've raised, but only if I am not at the fundraising minimum of $1000.

Credit Card

Card Type:
Credit Card Number:
Credit Card Expiration (mm/yy): /
Name On Card:
CVV Value:

Billing Address

Zip Code:
Country, if not US: