Orange Descent Canoe Marathon Entry form
BOAT NUMBER
*
CLASS
K2
K1
K3
*
Paddler One
fields marked with * are required fields
CSA Registration Number:
*
Name:
*
ID Number:
*
Club:
*
Date of Birth:
*
Sex:
male
female
*
Postal Address:
*
Postal Code:
*
Telephone:
*
Mobile Phone:
*
E-mail:
*
Verify your e-mail address:
*
T-Shirt size:
x-small
small
medium
large
x-large
xx-large
xxx-large
*
Entry:
Senior - R450
Junior - R250
* per paddler
Paddler Two
fields marked with * are required fields
CSA Registration Number:
*
Name:
*
ID Number:
*
Club:
*
Date of Bith:
*
Sex:
male
female
*
Postal Address:
*
Postal Code:
*
Telephone:
*
Mobile Phone:
*
E-mail:
*
verify your e-mail address:
*
T-Shirt size:
x-small
small
medium
large
x-large
xx-large
xxx-large
*
Entry:
Senior - R450
Junior - R250
* per paddler
Paddler Three
fields marked with * are required fields
CSA Registration Number:
*
Name:
*
ID Number:
*
Club:
*
Date of Bith:
*
Sex:
male
female
*
Postal Address:
*
Postal Code:
*
Telephone:
*
Mobile Phone:
*
E-mail:
*
verify your e-mail address:
*
T-Shirt size:
x-small
small
medium
large
x-large
xx-large
xxx-large
*
Entry:
Senior - R450
Junior - R250
* 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
Finish here >
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.