2018 Packraft Roundup Registration Form

Select the number of participants in your group (14 years and older) registering for the Roundup today: *

Select the Quantity of participants 14 years and older in your group... *

2018 Packraft Roundup $ 100.00

Quantity

Enter coupon

Total $ 0.00

Are any participants in your party 13 years old or younger? *

Participant #1's Full Name *

First Name Last Name

Participant #1's Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Participant #1's E-mail *

Participant #1's Mobile Phone Number *

- Country Code - Area Code Phone Number

If you are a member of the American Canoe Association, please enter your member number here:

Participant #1: Please rate your paddling ability...

Participant #1: Please indicate your packrafting experience...

Participant #2's Full Name *

First Name Last Name

Participant #2's E-mail *

Participant #2's Mobile Phone Number *

- Country Code - Area Code Phone Number

If this person is a member of the American Canoe Association, please enter their member number here:

Please rate the paddling ability of Participant #2...

Please indicate the packrafting experience of Participant #2...

Participant #3's Full Name *

First Name Last Name

Participant #3's E-mail *

Participant #3's Mobile Phone Number *

- Country Code - Area Code Phone Number

If this person is a member of the American Canoe Association, please enter their member number here:

Please rate the paddling ability of Participant #3...

Please indicate the packrafting experience of Participant #3...

Participant #4's Full Name *

First Name Last Name

Participant #4's E-mail *

Participant #4's Mobile Phone Number *

- Country Code - Area Code Phone Number

If this person is a member of the American Canoe Association, please enter their member number here:

Please rate the paddling ability of Participant #4...

Please indicate the packrafting experience of Participant #4...

Participant #5's Full Name *

First Name Last Name

Participant #5's E-mail *

Participant #5's Mobile Phone Number *

- Country Code - Area Code Phone Number

If this person is a member of the American Canoe Association, please enter their member number here:

Please rate the paddling ability of Participant #5...

Please indicate the packrafting experience of Participant #5...

Participant #6's Full Name *

First Name Last Name

Participant #6's E-mail *

Participant #6's Mobile Phone Number *

- Country Code - Area Code Phone Number

If this person is a member of the American Canoe Association, please enter their member number here:

Please rate the paddling ability of Participant #6...

Please indicate the packrafting experience of Participant #6...

Please provide full names and ages of participants in your group under 14 years of age...as well as parental contact information if different from your own... *

Number of motor vehicles that your party will be using to travel to the Roundup:

Type of vehicle(s) that your party will bring to the Roundup:

small car, station wagon, camper van, or pickup truck pull-behind camper trailer (no motor drive) large motorhome RV motorcycle

(To register by mail, please provide the information requested on this form, and include it with a check for the above amount to American Packrafting Association, PO Box 13, Wilson, WY 83014. If you are paying by check, you do not need to click "Register.")