2021 Course Registration Form

2021 Course Registration Form

Canoe, SwiftWater Rescue & Packrafting
Personal Information

Please fill as completely as possible
Full Name *

First Name Last Name
Phone Number *

Area Code
E-mail *
Cell Number *

Area Code Phone Number
Address

Street Address

Street Address Line 2

City Province/ State

Country
Age
Weight (lbs) *
Height (feet) *
Swimming Ability *
Wetsuit/Drysuit *

Will use a wetsuit I will rent a drysuit I have my own
Newsletter

Yes, add my email to the Yukan Canoe Newsletter.
Are you Registering Additional People on this Form

Yes No
Additional People you are registering with this form
Medical and Emergency Contact Info for all Registrations
Medications *
Medical Conditions *
Emergency Contact person *

First Name Last Name
Medical Information for all Registrants including Allergies
Phone Number *

Area Code Phone Number
Relationship
Course Selection

Please start by selecting the type of courses(s) you're registering for. Next, pick your course dates below. You will then need to select and pay for course in the Course Payment Section
Course Name

Intro to Moving Water Whitewater Fundamentals Level 2 Lapie River Extravaganza Swift Water Rescue Intro to Solo Playboat Intermediate Solo Playboat Advanced/Intermediate Solo Playboat - Lapie River Solo - Tripping Canoes Packraft 101- Intro Packraft 102-Whitewater skills
Intro to Moving Water Level 1 Thursday Evening all day Sat/Sunday

June 10,12,13(wait list)
Intro to Moving Water Level 1 Friday Evening all day Sat/Sunday

June 18,19,20 June 25,26,27 July 9,10,11 July 16,17,18
For 2021 we have course start days on either Thursday or Friday evening. We require a minimum of 4 people per course. Are you flexible for either Thurs or Fri evening?

Yes No
Whitewater Fundamentals Level 2 Thursday Evening, all day Sat/Sunday

June 24,26,27(wait list)
Whitewater Fundamentals Level 2 Friday Evening, all day Sat/Sunday

June 18,19,20(wait list)
Whitewater Skill Building Series- Solo

May 8 May 15 May 22 May 29 All
Whitewater Skill Building Series-Tandem

May 6 May 13 May 20 May 27 All
Lapie River Extravaganza - 4 day whitewater course

June 26,27,28,29 (wait list) July 1,2,3,4 (wait list) July 8,9,10,11 (wait list)
Swift Water Rescue - 2 Evenings 2 Full Days

July 15,16,17,18
Intro to Solo Playboat

June 15,16,18,21 (wait list) Custom dates please email
Intermediate Solo Playboat

June 16,17,21 Custom Dates Please Email
Advanced/Intermediate Solo Playboat- Lapie River

July 8,9,10,11 Custom Dates Please Email
Solo-Tripping Canoes

June 18,20,21(wait list) Custom dates Please email
Packraft 101- Intro to Packrafting

June 15-16 June 22-23 June 14
Packraft 102- Whitewater Skills

June 19-20 July 17-18
Extra Information for Custom Courses or other details we should be aware of before the course.
Extra Student Details- Include information like: friends that are signing up for same course, mobility challenges, Custom course info, etc.
Where did you hear about Yukan Canoe- please check all that apply

Yukon News Whitehorse Star online Google Search CKRW Posters Friends word of mouth Kanoe People Up North Padding Mag. North of Ordinary What's Up Yukon Email campaign Media screens Online advertising
If the course you have chosen does not have the required minimum of 4 students are you willing to pay 25% more so the course can run? We are offering this option to be able to have more courses run. Asking on this form will save us from asking later in the case of low registrations.

Yes No
Online Payment Section- Pay for your courses here. All students will be required to sign a waiver. Please read our cancellation policy before registering.

Pay for all participants registered on this form.

COURSE ONLINE PAYMENT SECTION

Tandem Canoe

Intro to Moving Water $ 249.00 CAD

Quantity
Item subtotal: $ 0.00 CAD

Whitewater Fundamentals Level 2 $ 299.00 CAD

Quantity
Item subtotal: $ 0.00 CAD

Lapie River Extravaganza $ 499.00 CAD

Quantity
Item subtotal: $ 0.00 CAD

Solo Canoe

Intro to Whitewater Solo Playboating $ 299.00 CAD

Quantity
Item subtotal: $ 0.00 CAD

Intermediate Whitewater Solo Playboating $ 299.00 CAD

Quantity
Item subtotal: $ 0.00 CAD

Intermediate/Advanced Solo Playboat $ 499.00 CAD

4 day whitewater course

Quantity

Intro to Solo Tripping $ 299.00 CAD

Solo Tripping Canoe Course taught is regular size canoes

Quantity
Item subtotal: $ 0.00 CAD

Swift Water Rescue

Swift Water Rescue $ 299.00 CAD

Quantity

Packrafting

Packraft 101 $ 160.00 CAD

2 evening Intro to Packrafting. 1 evening on lake 1 on Yukon River

Quantity

Packraft 102 $ 275.00 CAD

2 River Days Whitewater Packrafting Skill building

Quantity

Drysuit + Booties

Drysuit rental $ 35.00 CAD

We will pick size based on height/weight on form.

Quantity
Item subtotal: $ 0.00 CAD

Bootie Rental $ 15.00 CAD

Old running shoes work well

Size Quantity
Item subtotal: $ 0.00 CAD

Neoprene Sock purchase $ 25.00 CAD

size Quantity

Enter coupon

Subtotal $ 0.00 CAD Tax $ 0.00 CAD Total $ 0.00 CAD

Payment Method

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Billing Address
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Additional Information
Should be Empty:

2021 Course Registration Form

Personal Information

Medical and Emergency Contact Info for all Registrations

Course Selection

Extra Information for Custom Courses or other details we should be aware of before the course.

Online Payment Section- Pay for your courses here. All students will be required to sign a waiver. Please read our cancellation policy before registering.