2022-2023 CLUB WAIVER
Check if guest paddler
I am a Guest Paddler (Vistors, Other team,2-Session Pass)
Club Member (Full Membership)
Check if under the age of 18 years old (At the time of registration)
Minor - U18
Date:
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit 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
2 digit month, 2 digit day, 4 digit year
Date
Emergency Contact #
Signature of Parent/ Legal Guardian
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