2022 CLUB WAIVER

2022 CLUB WAIVER
Check if guest paddler

I am a guest paddler
Check if under the age of 18 years old (At the time of registration)

Minor - U18
Date: *

Month Day Year
Date
Participant / Member Name: *
Address: *
Phone Number: *
Email Address: *
Signature *
FOR PARTICIPANTS OF MINOR AGE

(UNDER AGE 18 AT THE TIME OF REGISTRATION)
Parent / Legal Guardian Name
Minor DOB:

Month Day Year
Date
Emergency Contact #
Signature of Parent/ Legal Guardian
Should be Empty:

FOR PARTICIPANTS OF MINOR AGE