CONTACT INFORMATION
Name:
Address:
City:
Province
or State:
Ontario
British Columbia
Alberta
Saskatchewan
Manitoba
Quebec
Newfoundland
Nova Scotia
New Brunswick
Prince Edward Island
Yukon
Northwest Territory and Nunavut
Postal/Zip Code:
Email:
Home Telephone:
Work Telephone:
Where did you hear about us?
printed brochure
newspaper ad
from a friend
net search
returning client
other
COURSE INFORMATION
Which course/trip are you registering for?
White Water Kayak/Canoe Weekends
Lakewater Canoe Weekends
Eskimo Rolling Clinics for Kayak/Canoe
Kayaking '101'- McMaster
Whitewater Canoeing in Algonquin Park
Basic Instructor Canoe Course
Kayaking Instructor Courses
Week of Rivers
Costa Rica
Ottawa River Rafting or Kayaking
Choose a Course
What dates do you prefer?
If this course is full, do you have a 2nd Choice?
White Water Kayak/Canoe Weekends
Lakewater Canoe Weekends
Eskimo Rolling Clinics for Kayak/Canoe
Kayaking '101'- McMaster
Whitewater Canoeing in Algonquin Park
Basic Instructor Canoe Course
Kayaking Instructor Courses
Week of Rivers
Costa Rica
Ottawa River Whitewater Rafting or Kayaking
Choose a Course
What dates do you prefer?
Can you swim 100 metres in a life jacket? Yes without?
Describe your
paddling experience:
Do you prefer to use a Kayak or Canoe
Certification Desired?
Yes (Type Level )
Note: ORCA certification is subject to successful demonstration of skill standards.
Please add $15 processing fee for courses in which you want certification.
HEALTH INFORMATION
Age: Height: ft inches
Weight: lbs Shoe Size
Health History:
Describe all relevant medical conditions in detail, i.e., allergies, recent injuries,
illnesses, operations, general health level, disabilities, phobias, etc.
Health Number:
Doctor's Name:
Telephone:
In case of an emergency, phone (name)
Telephone:
Note: You will be required to read and sign a Waiver of Liability. Participants must be at least fourteen years of age or have written permission by their guardian. Need to cancel? A refund (excepting a $50 service charge) will be provided until 7 days prior to course date after which a refund is available only if we can fill your vacancy. A non refundable payment in full is required for the Ottawa river trips, 30 days in advance. Upon receipt of the Registration Form, you will be provided with information describing whrere/when we meet etc. API reserves the right to cancel any course with a full refund to registrants' i.e. less than three registrants.