First Name Last Name

Phone

Email

Street Address

City State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip:

Gender Male Female

Age

Racer 2

First Name Last Name

Phone

Email

Street Address

City State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip

Gender Male Female

Please reserve one canoe for me/us. I/we agree to pay the $35 fee by mail along with my/our registration fee or I/we will pay the rental fee on the day of the race.

Competition category

Racing Class (A1) Single person Kayak
Racing Class (A2) Mixed canoe
Racing Class (A3) Womens canoe
Racing Class (A4) Mens Canoe
Casual Paddlers (B) Any combination men, women and-or kids (up to 4)

Type the following: For security purposes, please type the letters in the image.