MOONLIGHT REGISTRATION: Please print and bring the completed form with you.
Please call or e:mail us for advance reservation for food and people count
.

Moonlight on Odessa -

Name ___________________________________________Age ________

Address __________________________________________________

City, State, Zip_____________________________________phone____________________

E:mail (please print clearly)_________________________________________

second person:

Name ___________________________________________Age ________

Address __________________________________________________

City, State, Zip______________________________________phone_________________

E:mail (please print clearly)_________________________________________

I recognize that there is an element of risk in any outdoor activity. Knowing of the inherent risks, dangers and rigors, I certify that I and my family are fully capable of participating in this paddle trip. I assume full responsibility for my personal property and expenses while participating in this event. I agree to hold harmless River Basin Canoe & Kayak. I also give River Basin Canoe & Kayak permission, without limitation, to use any photographs that might be taken of me while participating in this event.

Signature _________________________________________________ Date _______________________

Signature _________________________________________________ Date _______________________

Registration Fee

____# participants @ $25……………………….…………… $____________

____# canoe rentals @ $25 ( includes paddles & PFD)...............$___________

____# kayak rentals (call to reserve) @ $30 sngl, $40 dbl...........$___________

____# non paddlers - cook out only @ $5..................................$____________

Total ..................................... ....................................................$____________Add 7% tax please

Advance reservation is required. THANK YOU.
Please call with your credit card information.