Info Form - Intro to Hard Shell Kayaking — Adobe Whitewater Club

Intro to Hard Shell Kayaking Participant Information Form

Name

First Name

Last Name

Email

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

American Canoe Association (ACA) Membership Number

If not a member, enter zeros

American Canoe Association (ACA) Expiration (if member)

MM

DD

YYYY

Emergency Contact

First Name

Last Name

Emergency Contact Phone

(###)

###

####

You must pay for the clinic before your registration is complete. Clicking on SUBMIT will take you there.