TICC Safe Canoeing Registration Form

Safe Canoeing Registration Form

This form is for adults 18+
Registrant Details
Sunday May 18 10am -2pThursday June 12 6p-9pMonday June 30 10am-2pSunday July 6 10am-2pSaturday July 5 10am-2pm
Sunday May 17 10am -2pTuesday June 16 5-8pSunday May 24 10am-2pWednesday June 24 5-8p
Full Name*

First NameLast Name
Date of Birth:*

MonthDayYear
month-day-year
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Format: (000) 000-0000.
E-mail*
example@example.com

Emergency Contact: *

Rows	Full Name	Contact Number	Relationship
1

OHIP Health Card Number*
include version code
yesno
Never been in a canoeHave been in a canoe once or twiceSome experience paddlingI have experience paddling in bow and stern
Do you have any health issues we should be aware of? If none, write NONE*

Rows Description

1
How did you hear about us?*
Please Specify*
ORCKA Required Waiver- read and check acknowledgement
I acknowledge that I have read and accept the conditions outlined in the above ORCKA Waiver.*
Type your name here as signature
This Waiver has been witnessed by, please type your name here*
Type your name here as signature
Refund Policy

We will refund your money in full should we cancel the course you registered for due to under registration, weather or other safety issues. If you choose to cancel your participation more than 14 + days in advance of the course date, we will refund you your payment less $25 for administrative fees. No refunds within two weeks of the course date.

Rows	Description
1

My Products*

Safe Canoeing Course Sunday May 17 10am -2p

ORCKA Safe Canoeing 3-4 hour on water course for beginners. After this course you should feel comfortable paddling in calm conditions.

$50.00CAD Quantity

Safe Canoeing Course Sunday May 24 10am-2pm

ORCKA Safe Canoeing 3-4 hour on water course for beginners. After this course you should feel comfortable paddling in calm conditions.

$50.00CAD Quantity

Safe Canoeing Course Tuesday June 16 5pm-8pm

ORCKA Safe Canoeing 3-4 hour on water course for beginners. After this course you should feel comfortable paddling in calm conditions.

$50.00CAD Quantity

Safe Canoeing Course Wednesday June 24 5pm-8pm

ORCKA Safe Canoeing 3-4 hour on water course for beginners. After this course you should feel comfortable paddling in calm conditions.

$50.00CAD Quantity

Enter coupon

Total

$0.00CAD

Safe Canoeing Registration Form