2026 Coast 2 Coast Registration Form

Registration Form

For 2026 Coast 2 Coast Participants
Runner's Information
Last Name*
First Name*
MaleFemale
Nationality
Address*
City*
State*
Zip*
Birth Date*

DayMonthYear
C2C 444km (own support crew)C2C 444km (need help to find support crew)C2C 444km (Relay team of 2, 3, 4, 5 or 6 runners)
IC/Passport Number
Work Phone*

Area CodePhone Number
Cell Phone

Area CodePhone Number
Emergency Contact Info
Emergency Contact Name(if parent or guardian is not avaliable)*
Emergency Number*

Area CodePhone Number
Emergency Number #2*

Area CodePhone Number
Email Confirmation
Runners's Email
Health Information

A health officer is on site at all times.
List all medications, both prescribed and over the counter, all medications will be turned into the health officer except rescue inhalers, bring all medication in original containers.
List any allergies (ex: bees,peanuts, dairy)
Any dietary needs that we should know about?
Runners Photo Release
YesNo
- Be certain to enter your email address correctly on the registration form to receive confirmation via email with in 2 weeks
Electronic signature, please initials*
Should be Empty:

Registration Form