Request edit access
Parksville 360 2022 Registration
April 9-10 2022
Information will be collected for planning purposes only and will not be shared outside the organizers, support and first aid for the ride as needed.

Sign in to Google to save your progress. Learn more
First and Last name *
Email *
Cell Phone Number *
What is your average riding pace in KM/Hr? *
I understand that it is my responsibility to study and know the route prior to departure. *
Required
I understand that I am responsible for providing my own personal food items above and beyond the goodies that will be supplied in the support vehicles. A full list of goodies will be published prior to the ride. *
Required
I acknowledge that it is my responsibility to book my own accommodation. *
Required
Will you be riding both ways (360km) or one way (180km)? Ability to ride one way is limited and based on spaces available in support vehicles.   *
Name and phone number of emergency contact *
Do you have any food allergies? if so please list, and indicate treatment. Please confirm you will be carrying treatment. *
Do you have any allergies that could pose a risk to your health in an emergency situation? if so, please list.  Listing allergies acknowledges you agree to disclose them to the first aid support on the team.   *
Do you have any relevant medical conditions the team needs to be aware of prior to departure? If yes, you acknowledge you must disclose them to the first aid support on the team.  
I understand that to secure a spot for the ride, an e-transfer of $80 dollars to rfmendurance@gmail.com must be sent. *
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report

Google Forms