Media Credential Request Form

Media Credential Request Form

All media outlet personnel and anyone wanting to produce content from a Coast 2 Coast Preps event must complete this registration form.
Filling out this form does NOT automatically mean you are approved to cover the event.

Every event you attend, you must check in an get the proper event media pass.

Please fill out all fields, review, and sign below.

Approval will be sent via email to the email address you have provided.

If you have any questions, please email coast2coastpreps@gmail.com
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Type of Media

VideographerPhotographerScoutWriter
Upload a Headshot

Cancelof
What do you plan on covering, creating, and doing while in the event?
Company Instagram Handle
Company Tik Tok Handle
Company Twitter Handle
Company Website
Gender

MaleFemaleUnspecified
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Signature

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Should be Empty: