Complete this form to register for C2K 2022. Riders - Volunteers - Supporters - Sponsors RM_StatsMain registrationEmail *First name *Last name *Gender * Male Female Date of Birth *Age *Address Country Afghanistan Aland Islands Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas, The Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Bouvet Island Brazil British Indian Ocean Territory Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Christmas Island Cocos (Keeling) Islands Colombia Comoros Congo Congo, The Democratic Republic Of The Cook Islands Costa Rica Cote D'ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Falkland Islands (Malvinas) Faroe Islands Fiji Finland France French Guiana French Polynesia French Southern Territories Gabon Gambia, The Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guadeloupe Guam Guatemala Guernsey Guinea Guinea-Bissau Guyana Haiti Heard Island and the McDonald Islands Holy See Honduras Hong Kong Hungary Iceland India Indonesia Iraq Iran Ireland Isle Of Man Israel Italy Jamaica Japan Jersey Jordan Kazakhstan Kenya Kiribati Korea, Republic Of Kosovo Kuwait Kyrgyzstan Lao People's Democratic Republic Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macao Macedonia, The Former Yugoslav Republic Of Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Martinique Mauritania Mauritius Mayotte Mexico Micronesia, Federated States Of Moldova, Republic Of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands Netherlands Antilles New Caledonia New Zealand Nicaragua Niger Nigeria Niue Norfolk Island Northern Mariana Islands Norway Oman Pakistan Palau Palestinian Territories Panama Papua New Guinea Paraguay Peru Philippines Pitcairn Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Barthelemy Saint Helena Saint Kitts and Nevis Saint Lucia Saint Martin Saint Pierre and Miquelon Saint Vincent and The Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa South Georgia and the South Sandwich Islands Spain Sri Lanka Sudan Suriname Svalbard and Jan Mayen Swaziland Sweden Switzerland Taiwan Tajikistan Tanzania, United Republic Of Thailand Timor-leste Togo Tokelau Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Turks and Caicos Islands Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States United States Minor Outlying Islands Uruguay Uzbekistan Vanuatu Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Wallis and Futuna Western Sahara Yemen Zambia Zimbabwe Mobile number *Phone numberMedical DetailsEmergency contact *Medical contactMedicare numberDo you have private medical insurance ? * Yes No Do you have allergies ? * Yes No If Yes, tell us what you are allergic toDo you carry an epipen ? * Yes No Do you have any medical concerns you feel we should know about ? * Yes No If Yes, please let us know what they are.Have you recently had any kind of surgery ? * Yes No If Yes, what surgery have you had ?When was your last tetanus booster ? * Less than 1 year 1 to 2 years More than 2 years ago Catering RequirementsOur catering crew try to cater for most dietary preferences. However, please consider bringing along any specific dietary items you may uniquely need as cooking in bush kitchens may sometimes pose a challenge to specifically cater for individuals' needs.Do you have any food allergies? * Yes No What are you allergic to?Do you have any dietary preferences * Yes No Tell us about your dietary preferences.Select your registrationSelect your registration *Select an option7 Day Dirt rider ($ 1025)7 Day Road rider ($ 980)3 Day Road rider ($ 445)1 Day Road rider ($ 200)Road rider 15 to 18 years ($ 330)Road rider less than 15 years ($ 250)Pack leader (Road/Dirt) ($ 530)Supporter ($ 955)Volunteer ($ 100)Non rider 12 to 18 years ($ 200)Non rider 8 to 11 years ($ 100)Non rider less than 8 years ($ 25)Please confirm your participation selection *Select an optionRoad RiderDirt RiderPack Leader (Road)Pack Leader (Dirt)SupporterVolunteerSponsorNon RiderSelect the Road Pack you would like to ride with.Select an optionPack 1 – 35 km/h plusPack 2 – 28-34km/hrPack 3 – 25-28 km/hPack 4 – 22-25 km/hrPack 5 – 20-22 km/hPack 6 – 18-20 km/hJersey Type (Road & Dirt Riders Only) Short Sleeve Long Sleeve Jersey Style (Road & Dirt Riders Only) Male Female Jersey Size (Road & Dirt Riders Only) XS S M L XL 2XL 3XL 4XL 5XL Knicks Type - available FREE for Pack Leaders OnlySelect an optionMaleFemaleKnicks Size - available FREE for Pack Leaders OnlySelect an optionXSSMLXLXXLPolo size (unisex) - For Supporters and Non Riders Only XS S M L XL 2XL 3XL 4XL 5XL Indicate the sizeAre you part of a Team ? If yes let us know your Team's nameEnter your Team's nameJersey Size chart or Polo Size chart Other important InformationWould you like to purchase a Gulflander train ticket ? Yes ($ 20) × This is a tour in Croydon that lasts approx 2 hours.Do you need a return bus ticket ? Yes ($ 110) If you are an unsupported rider you will need this to return back to Cairns from Karumba.Do you need Breakfast at Normanton on the way back ? Bacon & Egg Roll (GF Bread) ($ 10.00) × Toasted Sandwich (Ham & Cheese) (GF Bread) ($ 7.00) × Toasted Sandwich (Ham, Cheese & Tomato) (GF Bread) ($ 7.00) × Salad Roll (GF Bread) ($ 8.00) × Salad Sandwich (GF Bread) ($ 8.00) × Fresh Fruit Salad ($ 7.50) × Indicate what you want for breakfastHow did you hear about our ride?Select an optionI have participated beforeA friendGoogle SearchSaw it on social mediaSaw an ad on an in-flight magazinesRadioTVOther Cancellation Policy If you register and are unable to attend the ride you have the following options: a) Transfer your registration to the following year b) Transfer your registration to a friend c) Receive a 50% refund if made more than 30 days prior to the event. No refund is provided for cancellation made less than 30 days from the event start date. If you are paying a deposit only. Your deposit is non-refundable. The full amount of your registration must be paid by no later than 30 days prior to the ride. (31 May 2022). Payments should be made directly into the charity's bank account, using your name as reference. Bank details below: Milboe Ltd, Bendigo Bank | BSB 633 000 | Account 136 988 722 Failure to pay your balance on time will result in you registration being cancelled. I have read and understand the cancellation policy. * Yes Indicate if you have read the cancellation policy I understand that participating in this event is potentially hazardous, and that I should not enter and participate unless I am medically able and properly trained. I take sole responsibility for my bike and any equipment I take with me to the event. I take sole responsibility in loading, unloading my bike on and off any trailers and storing my bike. I understand that I must fundraise the required amount stipulated in the Registration Fees section in order to participate in the event. In consideration of the acceptance of this entry, I assume full and complete responsibility for any injury or accident which may occur while I am traveling to or from the event, during the event, or while I am on the premises of the event. I am aware of and assume all risks associated with participating in this event, including but not limited to falls, contact with other participants, effect of weather and spectators. I, for myself and my heirs and executors, hereby waive, release and forever discharge the event organizers, sponsors, promoters and each of their agents, representatives, successors and assigns, and all other persons associated with the event, for all my liabilities, claims, actions, or damages that I may have against them arising out of or in any way connected with my participation in this event. I understand that this waiver includes any claims, whether caused by negligence, the action or inaction of any of the above parties, or otherwise. I hereby grant full permission to any and all of the above parties to use any photographs, videotapes, motion pictures, website images, recordings or any other record of this event. I have read and understand the Terms and Conditions * Yes Indicate if you have read and agree to the terms and conditionsWhen you click on "Submit" you will be directed to our PayPal payment portal. You can pay with your credit card or PayPal account. If you exit before completing your payment your registration will not be submitted. Receive updates leading up to the ride. Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.
Riders - Volunteers - Supporters - Sponsors
Our catering crew try to cater for most dietary preferences. However, please consider bringing along any specific dietary items you may uniquely need as cooking in bush kitchens may sometimes pose a challenge to specifically cater for individuals' needs.
Jersey Size chart or Polo Size chart
If you register and are unable to attend the ride you have the following options: a) Transfer your registration to the following year b) Transfer your registration to a friend c) Receive a 50% refund if made more than 30 days prior to the event. No refund is provided for cancellation made less than 30 days from the event start date.
Your deposit is non-refundable. The full amount of your registration must be paid by no later than 30 days prior to the ride. (31 May 2022). Payments should be made directly into the charity's bank account, using your name as reference. Bank details below: Milboe Ltd, Bendigo Bank | BSB 633 000 | Account 136 988 722 Failure to pay your balance on time will result in you registration being cancelled.
I understand that participating in this event is potentially hazardous, and that I should not enter and participate unless I am medically able and properly trained. I take sole responsibility for my bike and any equipment I take with me to the event. I take sole responsibility in loading, unloading my bike on and off any trailers and storing my bike. I understand that I must fundraise the required amount stipulated in the Registration Fees section in order to participate in the event. In consideration of the acceptance of this entry, I assume full and complete responsibility for any injury or accident which may occur while I am traveling to or from the event, during the event, or while I am on the premises of the event. I am aware of and assume all risks associated with participating in this event, including but not limited to falls, contact with other participants, effect of weather and spectators. I, for myself and my heirs and executors, hereby waive, release and forever discharge the event organizers, sponsors, promoters and each of their agents, representatives, successors and assigns, and all other persons associated with the event, for all my liabilities, claims, actions, or damages that I may have against them arising out of or in any way connected with my participation in this event. I understand that this waiver includes any claims, whether caused by negligence, the action or inaction of any of the above parties, or otherwise. I hereby grant full permission to any and all of the above parties to use any photographs, videotapes, motion pictures, website images, recordings or any other record of this event.
When you click on "Submit" you will be directed to our PayPal payment portal. You can pay with your credit card or PayPal account. If you exit before completing your payment your registration will not be submitted.
