Lead Participant Information

Lead Participant Expression of Interest

Personal Details

Yes
No
18km - Walk the full distance of the summit without a wheelchair
9km - Walk half the distance of the summit without a wheelchair and complete the remaining distance with a wheelchair
5km - Walk 5km without a wheelchair and complete the remaining distance with a wheelchair
I don't expect to walk - I will use the wheelchair the whole distance

Fundraising

Fundraising is a component of the Krazy Kosci Klimb. Funds raised support the Health and Wellness Program at Cerebral Palsy Alliance.

Yes
No, I would like some more information by email
No, I would like a phone call to learn more

By clicking “Submit”, I confirm that:

  1. The information provided in this EOI form is true, accurate and complete to the best of my knowledge;
  2. I understand that my personal information will be collected and used in accordance with Krazy Kosci Klimb : Privacy and Cerebral Palsy Alliance's Privacy Policy