Media Registration

First Name  
Last Name  
Work Phone  
Mobile  
Fax  
Email  
Publication Name  
Publication Type Newspaper  Magazine  TV  Internet  Radio  Other 
Publication Frequency Daily  Weekly  Monthly  Quarterly  Annual 
Filing Frequency Daily  Every Second Day  3 Times  Twice  Once  Never 
Publication Description  
Circulation  
Approx Publication Date  
Athletes to Feature  
Freelance/Staff Freelance  Staff 
Do require access to Media Boats Yes  No 
Will you be attending social functions? Yes  No 
Other requirements