banner
Coastlongboarding

Registration for

JAKES RASH "RACE"

Complete the form below to register for JAKES RASH "RACE"!

Details:

  • PAY ONLINE TO RECEIVE YOUR FREE RACER SHIRT OR JUST BRING YOUR CASH ENTRY TO Racer Registration & Mandatory Racer Meeting on Saturday @ The Pender Harbour Legion in Madeira Park…..MISS THIS MEETING YOU DON'T RACE!

CONTACTS

First Name



Last Name



Sponsors (optional)



Age



Gender



Medical Number (if you have one)



Emergency Contact Name



Emergency Contact Phone Number



 

Email Address



Phone Number



Address, Street



City/Town



Country



Postal/Zip Code

OPTIONS

Race Class - Choice 1



Race Class - Choice 2 (optional)



Shirt Size



COMPLETION



Contact: coastlongboarding@shaw.ca

© 1997 - 2026 COASTLONGBOARDING