2004 Whitewater Kayak Schools
Registration Form

Please print clearly, one form per person, photocopies okay.

Select Session(s):

Kayak I School

Eskimo Roll School

 
 

    

Session ___________

Session ___________

 
 

    

Cost ____________

Cost ____________

Total
Enclosed ________

 

Name ________________________________________________________

Address_______________________________________________________

City __________________________ State _________ Zip______________

Phone ( _______ ) ______________________________________________

E-mail Address_________________________________________________

Membership #____________ Gender ____ Height_______ Weight _______

 
Select one:

___ I have my own gear - or - ___ I need to use COP gear

Please list any physical/health conditions which should be known in case
of an emergency which may affect your participation in the class:

______________________________________________________________

______________________________________________________________

Send with your payment to:
Diane Larson, 1359 Meadow Road, Columbus, OH 43212

2004 Whitewater Kayak School Information

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