Orange Descent Canoe Marathon Entry form
BOAT NUMBER * CLASS *
   
Paddler One fields marked with * are required fields
CSA Registration Number: *
Name: *
ID Number: *
Club: *
Date of Birth: *
Sex: *
Postal Address: *
Postal Code: *
Telephone: *
Mobile Phone: *
E-mail: *
Verify your e-mail address: *
T-Shirt size: *
Entry: * per paddler
Paddler Two fields marked with * are required fields
CSA Registration Number: *
Name: *
ID Number: *
Club: *
Date of Bith: *
Sex: *
Postal Address: *
Postal Code: *
Telephone: *
Mobile Phone: *
E-mail: *
verify your e-mail address: *
T-Shirt size: *
Entry: * per paddler
Paddler Three fields marked with * are required fields
CSA Registration Number: *
Name: *
ID Number: *
Club: *
Date of Bith: *
Sex: *
Postal Address: *
Postal Code: *
Telephone: *
Mobile Phone: *
E-mail: *
verify your e-mail address: *
T-Shirt size: *
Entry: * per paddler
   
Special Categories:  
Novice   Perant & Child   Husband & Wife    Siblings   Mixed Doubles
   
INDEMNITY: I/We, the undersigned, hereby declare that I am/We are sufficiently competent to take part in the Orange Descent, assume all risks of participation in the Orange Descent, release and discharge the organisers and all their assistants as well as the sponsors from all claims arising for loss, damage, injury or death I/we may suffer arising from my/our participation in the race, and agree to abide by all the race and CSA rules, which I/we have read and understood. I further certify that the information above is correct .
   
Click for digital signature Paddler 1 Signature of parent or guardian in the case of persons under
       21 years old
Click for digital signature Paddler 2 Signature of parent or guardian in the case of persons under
        21 years old
Click for digital signature Paddler 3 Signature of parent or guardian in the case of persons under
        21 years old
   
Validate Registration
Key in the number displayed
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PLEASE NOTE:
By completing and submitting your race entry you acknowledge that you have read, understood and will abide by the race rules.

Please make sure that you make your payment and submit a proof of payment at the same time as faxing or emailing us your entry form. No entries will be processed.

Please use your Paddler 1 Boat Number as payment reference.