Swan Canoe Club Trip Registration Form

Swan Canoe Club Trip Registration Form
Two Islands Paddle 30 June 2024
First and Last Name
Mobile Phone Number
Please enter a valid phone number.Format: 0000 000 000.
Email Address
example@example.com
Emergency Contact Name
First and last name
Emergency Contact Mobile Phone Number
Please enter a valid phone number.Format: 0000 000 000.
Your vehicle make, model, colour and registration number or name of person you are travelling with
Boat type and colour
Paddler skill level (All paddlers must be able to paddle 13km)
Intermediate, Advanced, Guide, Instructor etc.
Please list any medical information or physical limitations that are appropriate for the guides to be aware of.
Are you a Swan Canoe Club member?
WARNING: Kayaking can be inherently dangerous. Serious accidents can happen which may result in injury or even death. RELEASE OF ACCEPTANCE OF RISK: Except where provided or required by law and such cannot be excluded, I am aware that there may be risks associated with kayaking and I do accept these risks and will hold Swan Canoe Club and its instructors free from liability, actions, causes of actions and demands for loss or injury to myself or my dependants. The terms hereof shall serve as a release and acceptance of risk for myself family and heirs. I have voluntarily read and understood this warning and accept and assume the inherent risks in kayaking.
Do you acknowledge and accept the above ACCEPTANCE OF RISK?
Should be Empty:

Two Islands Paddle 30 June 2024