Krazy Kosci Klimb : Register your interest

If you’ve heard about this amazing event and you are keen to join us we have several options for people wanting to take part in the Krazy Kosci Klimb. Whether you are a person living with a disability and would like to be one of this year’s Key Team Participants, a Corporate employee interested in sponsoring a team, or maybe you’d like to volunteer for our support crew we’d love to hear from you.

Participants must be over the age of 12 on the date of the event and have parental or guardian permission.

I'm registering my interest for: *

First name *

Last name *

Date of birth *

Address

Suburb

State

Postcode

Phone number *

Email *

What's the best way for us to contact you? *

Tell us a little bit about yourself

How did you hear about The Krazy Kosci Klimb?

What's your motivation to take on the challenge?

For Key Team participants only

Are you a customer of Cerebral Palsy Alliance? *

If so - what CPA centre do you attend?

What do you identify as your primary disability

Do you rely on a mobility aid?

If so, please specify your mobility aid

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