Register Your Team (Team Captain Only)

PaddlePalooza 2023 - TEAM CAPTAIN REGISTRATION FORM

Please complete this form to register for the event. "*" indicates required fields Please fill out by April 15th** or earlier Registration fee is considered tax deductible donation to Silver Lining Foundation

"*" indicates required fields

Team Information

Team Name/Motto:*

Home Location*

How many paddlers are on your team?*

Each paddler will be responsible for paying their entrance fee, please contact us at paddlepalooza2023@gmail.com to make other arrangements.

Do you need a canoe(s)?*

Yes

How Many Canoes Do you Need?*

How Many Canoes Are You Bringing?*

Team Captain Name*

First Last

Email*

Enter Email Confirm Email

Phone*

Shirt Size*

Gender*

Individual RELEASE OF LIABILITY WAIVER*

Checking this box is my acceptance of the terms of the waiver below.

In consideration of being allowed to participate in any way in this sports activity, related events and activities, the undersigned acknowledges, appreciates, and agrees that: The risk of injury or illness from the activities involved in this sport is significant, including the potential for permanent paralysis and death; and while particular safety rules, equipment, and personal discipline may reduce this risk, the risk of serious injury or illness does exist;

Payment Details

This form is payment for the captain and to hold your team place. You will be sent a form to send to each of your paddlers so they can register and pay their fee.

Captain's Fee - holds your team's place in Paddle Palozza 2023*

Price:

Each paddler will be responsible for paying their entrance fee, please contact us at paddlepalooza2023@gmail.com with questions. Once Captain form is submitted you will receive a form to send to your paddlers to register and pay their fee.

Payment Method

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Phone

This field is for validation purposes and should be left unchanged.

Register Your Team (Team Captain Only)

PaddlePalooza 2023 - TEAM CAPTAIN REGISTRATION FORM

Team Information

Payment Details

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