ZERO Peaks Challenge: Application Form

Application Form

We are thrilled that you're considering joining us on this remarkable journey to challenge yourself and take a powerful stand against prostate cancer. But before we hit the trail, we need some information from you. To help us understand your motivations and ensure your safety, well-being, and successful participation in this event, please take a moment to complete the application form below. All applications will be reviewed on a rolling basis.

Have questions about the application process or our program? Check out the Frequently Asked Questions page on our site or reach out to hike@zerocancer.org.

Your information:

Field Is Required First

Field Is Required Last

Field Is Required Street 1:

Street 2:

Field Is Required City/Town:

Field Is Required State / Province:

Field Is Required ZIP / Postal Code:

Field Is Required Email:

Field Is Required Phone Number:

By submitting this form, you consent to receive occasional emails from ZERO Prostate Cancer unless you have previously opted out. We will never sell your data and you can manage your communication preferences at any time.

Employer:

Your Pronouns:

Please answer the following questions to the best of your ability:

Field Is Required Age statement:

I will be 18 or older by the event date.
I am under the age of 18, and a parent or guardian is also applying and will accompany me on the trek.

Enter your parent or guardian's name:

Field Is Required 1. What is the highest elevation you have reached during your hiking or climbing experiences? [limit = 250 words]

Field Is Required 2. Please share details about any of your previous hiking experiences or similar endurance adventures. (i.e. a Marathon, Half Marathon, Triathlon, etc.). [limit = 250 words]

*Why are we asking this question? The safety of our participants is our top priority. Our hikes are strenuous, posing a potential danger to underprepared participants. Therefore, it is crucial that we ensure that all participants are sufficiently prepared both mentally and physically for the challenges they will encounter during the trek.

Field Is Required 3. How do you intend to physically prepare for this hike? [limit = 500 words]

Field Is Required 4. As part of the Prostate Cancer Peaks Challenge, you will have a specified fundraising requirement that you must reach in order to participate. Please briefly outline your strategy or approach for achieving your fundraising target. A general idea is sufficient at this stage; an in-depth plan is not required. [limit = 500 words]

Field Is Required 5. Do you have a connection to prostate cancer? [limit = 250 words]

*Why are we asking this question? You do not need to have a connection to prostate cancer to join the Prostate Cancer Peaks Challenge.

Field Is Required 6. ZERO Requires a medical clearance from a board-certified physician for all participants. Do you have any health concerns or physical limitations that may affect your ability to receive this clearance?

Yes
No
Unsure

If Yes or Unsure, please explain: (Maximum response 255 chars, approx. 5 rows of text)

Why are we asking this question? The safety of our participants is our top priority. Our hikes are strenuous, posing a potential danger to underprepared participants. ZERO will require medical clearance from a board-certified physician for all participants before booking travel.

Field Is Required 7. How did you find out about our event? (Select one of the available choices or enter a different value.) 7. How did you find out about our event? Click this to indicate that you will select an existing value. Tab to next input." 7. How did you find out about our event? 7. How did you find out about our event? Click this to indicate that you will enter a new value. Tab to next input." 7. How did you find out about our event? Provide your answer here

Field Is Required Are you familiar with ZERO Prostate Cancer? If so, explain: (Maximum response 255 chars, approx. 5 rows of text)

For questions about the application or our application process, please contact hike@zerocancer.org.

Application Form

ZERO Prostate Cancer, EIN: 59-3400922

ZERO Prostate Cancer,
EIN: 59-3400922