A Participant Agreement must be read and signed by all adult participants, and by a parent or guardian of minors.

Yes, I'm ready....Sign me up!

Paddler Registration

Name*
Address*
City* State* Zip*
Day Phone* Evening Phone
FAX
E-mail

* Required Information

Trip Information     For a summary, see prices.

Trip:

Number of Days 1/2, 9AM 1/2, 2PM 1 2

Number of Passengers: Adult Youth (17 and under)

Dates Preferred:
2nd Choice:

Boat Preference: Raft Inflatable Kayak Combo

Can you swim (not required) Yes No

Have you taken previous rafting trips (describe)

Payment Information

A deposit of 25% or $25 per person is required to hold your date. Upon receipt of your deposit we will send you written confirmation and information.

Mark this box if you would prefer that we call you for payment information.

Send confirmation by US Mail FAX E-mail

Deposit: 25%, or Number of Passengers X $25 =

Credit Card MasterCard VISA Discover American Express

Expiration Date
Card Number
Name as it appears on card

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