2023 Course Registration Form

2023 Course Registration Form

Canoe + SwiftWater Rescue
Personal Information

Please fill as completely as possible
Full Name*

First NameLast Name
Phone Number*

Area Code
E-mail*
Cell Number*

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityProvince/ State

Zip CodeCountry
Age
Weight (lbs)*
Height (feet)*
Swimming Ability*
Wetsuit/Drysuit -*

Will use a wetsuitI will rent a drysuit (please pay for rental below at time of registration.I have my own
Newsletter

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

YesNo
Additional People you are registering with this form
Medical and Emergency Contact Info for all Registrations
Medications*
Medical Conditions*
Emergency Contact person*

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

Area CodePhone 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 WaterWhitewater Fundamentals Level 2Lapie River ExtravaganzaSwift Water RescueIntro to Solo PlayboatIntermediate Solo PlayboatAdvanced/Intermediate Solo Playboat - Lapie RiverSolo - Tripping CanoesFrench Speaking Courses
Intro to Moving Water Level 1 Thursday Evening all day Sat/Sunday

May 18,20,21(wait list)June 1,3,4(wait list)June 8,10,11
Intro to Moving Water Level 1 Friday Evening all day Sat/Sunday

June 2,3,4(wait list)June 16,17,18 (wait list)July 14,15,16 (wait list)custom dates available
Intro to Moving Water Level 1 French Speaking Women Only ($299)

May 26,27,28 (Friday evening)
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?

YesNo
Whitewater Fundamentals Level 2 Thursday Evening, all day Sat/Sunday

June 1,3,4 (wait list)June 8,10,11 (wait list)June 15,17,18custom dates available
Whitewater Fundamentals Level 2 Friday Evening, all day Sat/Sunday

June 2,3,4 (wait list)June 23,24,25custom dates available
Whitewater Skill Building Series- Solo

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

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

June 30-July 3(wait list)July 6-9July 14-17custom dates availableJuly 10-13
Swift Water Rescue - 2 Evenings 2 Full Days or 3 full days

May 23-25 (wait list)May 30,31,3,4(wait list)custom datesJune 15,16,17,18(wait list)
Intro to Solo Playboat 2 evenings 1 full day

June 19,20,21custom dates
Intermediate Solo Playboat

June 8,10,11June 19,20,21custom dates
Advanced/Intermediate Solo Playboat- Lapie River

July 6-9custom dates
Solo-Tripping Canoes

May 19,20,21June 16,17,18(wait list)custom dates available
Packraft 101- Intro to Packrafting

see packraft registration form
Packraft 102- Whitewater Skills

see packraft registration form
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. Agency paying for course.
Where did you hear about Yukan Canoe- please check all that apply

Yukon NewsWhitehorse Star onlineGoogle SearchCKRWPostersFriendsword of mouthKanoe PeopleUp NorthPadding Mag.North of OrdinaryWhat's Up YukonEmail campaignMedia screensOnline advertisingYCKC
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.

YesNo
Online Payment Section- Pay for your courses here. All students will be required to sign a waiver. Please read our cancellation policy before registering. If an agency is paying for the course you must leave all below section blank.

Pay for all participants registered on this form.

COURSE ONLINE PAYMENT SECTION

Tandem Canoe

Intro to Moving Water$299.00CAD

Quantity
Item subtotal:$0.00CAD

Whitewater Fundamentals Level 2$399.00CAD

Quantity
Item subtotal:$0.00CAD

Lapie River Extravaganza$650.00CAD

Quantity
Item subtotal:$0.00CAD

Solo Canoe

Intro to Whitewater Solo Playboating$349.00CAD

Quantity
Item subtotal:$0.00CAD

Intermediate Whitewater Solo Playboating $399.00CAD

Quantity
Item subtotal:$0.00CAD

Intermediate/Advanced Solo Playboat$650.00CAD

4 day whitewater course

Quantity

Intro to Solo Tripping$379.00CAD

Solo Tripping Canoe Course taught is regular size canoes

Quantity
Item subtotal:$0.00CAD

Swift Water Rescue

Swift Water Rescue Assesment$50.00CAD

American Canoe Association Membership required to have skills assessment during the course. Must be selected before start of the course.

Quantity
Item subtotal:$0.00CAD

Swift Water Rescue$425.00CAD

ACA certificate of Participation

Quantity
Item subtotal:$0.00CAD

Drysuit + Booties

Drysuit rental$45.00CAD

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

Quantity
Item subtotal:$0.00CAD

Bootie Rental$15.00CAD

Old running shoes work well. Please indicate size for each rental. We only have unisex and full sizes

QuantitySize
Item subtotal:$0.00CAD

Neoprene Sock purchase$30.00CAD

sizeQuantity

Enter coupon

Subtotal $0.00CADTax $0.00CADTotal $0.00CAD

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:

2023 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. If an agency is paying for the course you must leave all below section blank.