Use this form to Register for the second CCC RACE DAY - Oct 5, 2024
Athlete's Full Name
*
First Name
Last Name
Paddler Date of Birth
*
-
Month
-
Day
Year
Date
*
Coach Name
Club Name
Name of Coach
*
Select Boat Class to Race
*
Male Canoe
Male Kayak
Female Canoe
Female Kayak
If you have partners for the "1-2-4 Race", enter team names below. If yo dont have partners but want to take part, enter your nmae and we will try to match you with others. If left blank, you will not be entered in this event.
Paddler Name
Kayak Paddler
Canoe Paddler
#1 - Your Name
#2 - Team member
#3 - Team member
#4 - Team member
Your Team Name (be creative)
Subway Lunch - all sandwiches will come with Lettuce, Tomatoes, Onions, & pickles, mustard and Mayo on the side. Lunch will come with a sandwich, snack, drink & cookie.
Type of Bread
Dairy free
Cold Cut Combo
Multigrain
Classic Italian
Gluten Free
Black forest ham
Multigrain
Classic Italian
Gluten Free
Turkey breast
Multigrain
Classic Italian
Gluten Free
Tuna
Multigrain
Classic Italian
Gluten Free
Veggie
Multigrain
Classic Italian
Gluten Free
Italian BMT
Multigrain
Classic Italian
Gluten Free
Contact information
*
Parent Contact
Additional Contact
Name
Email
Phone
E-mail to receive copy of this form (this will be main contact email, only 1 email please)
*
example@example.com
Signature of Parent or Guardian
*
Submit & Confirm with Payment
Should be Empty: