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1. Name (Required.)

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2. Contact Email Address: (Required.)

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3. Postal address (where materials can delivered to) (Required.)

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4. BB Company (or Battalion)? (Required.)

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5. Which sections will be participating in the challenge?

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6. What distance do you hope to cover? (miles) (Required.)

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7. Where do you plan to undertake your section? (trail name, approximate location etc) (Required.)

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8. When do you plan to undertake the challenge?

Date

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9. How do you plan to undertake the distance?

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10. Where did you find out about the 5000-mile Challenge? (Required.)

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11. Any additional comments?

T