Participant Name *

First Name

Last Name

Participant Phone Number *

(###)

###

####

Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone Number *

(###)

###

####

Please select the option that best describes your swimming ability. *

Non swimmer

Weak swimmer

Capable swimmer

I live in the water

Please select the option that best describes your paddling experience. *

What's a paddle?

I've paddled a few times

I have lots of paddling experience

Do you have any medical or physical limitations that may affect your ability to participate fully in Packraft Adventure Canada programs? *

Yes

No

Do you take any prescription medications on a regular basis? *

Yes

No

Do you have any allergies? *

Yes

No

Do you have any dietary restrictions that require a modified menu? *

Yes

No