TRIP - 202608 - SERPENTINE PADDLE Registration Form

SERPENTINE PADDLE Registration Form
Sunday 16th August 2026

Lead: Geoff Emery email: gemry13@gmail.com
Please note that you can use the tab button to jump to the next question
First and Last Name
Mobile Phone Number
Format: 0000 000 000.
Email Address
example@example.com
Emergency Contact Name
First and Last Name
Emergency Contact Mobile Phone Number
Format: 0000 000 000.
Your vehicle details or name of person you are travelling with
Do you have capacity to take another boat and passenger in your car?
Are you taking a club boat or your own boat?
Paddler Skill Level
Please list any medical information or physical limitations that are appropriate for the guide/instructor to be aware of (if none write na)
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.
Should be Empty:

SERPENTINE PADDLE Registration Form