Registration for 2021 « The Coastal Challenge

Category
Expedition Category (Approx 236 kms)Adventure Category (Approx 155 kms)

Participant
Yourself (18 or Older)Someone Else (18 or older)

Participant Information

First Name

Last Name

Gender
MaleFemale

Date of Birth

Email Address

Day Phone

Mobile Phone

If you are competing as part of a team, please specify team name:

Address

Country

Address Line 1

Address Line 2

Town / City

County

Postcode

Emergency Contact Details

Emergency contact name

Emergency contact phone

Emergency contact relationship

Emergency contact address

Medical Information

Do you suffer from any medical conditions
YesNo

Please list any medication you are taking

Dietary requirements

(Please note we cannot guarantee food provided on this event has been prepared in a nut free environment)

TERMS AND CONDITIONS

Do you have an interesting story? If so, we would love to hear from you – Send us your story to steve@thecoastalchallenge.co.uk and help inspire others.

By agreeing electronically, acknowledge that you have both read and understood all the text presented to you as part of the registration process.

I agree to the Terms and Conditions as set out here.

By Entering my name below, I assert that I have reviewed and agree to the above terms and conditions and will make the deposit payment within the next 7 Days.