2024 Paddle Canada Water Front Instructor Registration Form

2024 Yukan Canoe Paddle Canada Water Front Instructor Registration Form
Personal Information
Full Name*

First NameLast Name
E-mail*
Cell Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date of Birth
Weight *
Height*
Drysuit

I will rent a drysuitI have my own
Drysuit/Wetsuit Size

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Paddle Canada Membership Number
If you have a prior Paddle Canada Member #. If you do not remember you number if you can provide the email you would have used before with Paddle Canada we can look up.
Swimming Ability*
Medical and Emergency Contact Info for all Registrations
Medical Conditions*
Medical Information
Medications*
Medications Please list any and all
Emergency Contact person*

First NameLast Name
Phone Number*

Area CodePhone Number
Relationship
Course Selection Please Pick your courses here.
Professional Development Clinic

Dates to be determined
Water Front Instructor

May 3,4,5 (10 seats)May 13,14,15 (2 seats)
Please detail your paddling skill experience and any instructing/coaching experience you have. *
Will you require a receipt and completion letter for Tourism Training Fund, Department of Education or other?*

YesNo
Additional Information
Online payment option If you are paying online use below section. If any agency such as Dept. of Eduducation is paying for your course, please enter invoicing instructions in additional information box below and leave this section completely blank. 5% gst will be added to total. Please read our cancellation policy before booking your course. All participants will be required to sign both a Yukan Canoe and Paddle Canada waiver.

If you have any difficulties submitting the form, first check required fields or submit with out payment information.

My Products

Paddle Canada Waterfront Instructor $550.00CAD

Includes paddling equipment and Paddle Canada Waterfront 1 year Instructor Membership value of $50. GST will be added

Drysuit rental$25.00CAD

We will be in the water 1 afternoon learning and practicing rescues. Cold water immersion gear is highly recommend

sizeQuantity
Item subtotal:$0.00CAD

Bootie Rental$15.00CAD

SizeQuantity
Item subtotal:$0.00CAD

Neoprene Sock purchase$30.00CAD

sizeQuantity

Enter coupon

Subtotal $0.00CADTax $0.00CADTotal $0.00CAD

Payment Methods

Debit or Credit Card

Please click one of the PayPal options to complete payment and submit the form.

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2024 Yukan Canoe Paddle Canada Water Front Instructor Registration Form

Personal Information

Medical and Emergency Contact Info for all Registrations

Course Selection Please Pick your courses here.