6.

/1/06

Union River Salmon Run

Canoe & Kayak Race
Registration Form
June 24th, 2006 − Rain or Shine
ONE FORM REQUIRED FOR EACH PADDLER

Name______________________________________ Phone__________________________

Address______________________________________ E-mail _________________________

City__________________________________________State________Zip________________

Gender (circle one): Female / Male

Office use only:

FEES: $15 per person. Make Checks Payable to Payment recv. date:_______ Init: _____
"Union River Watershed Coalition."

Event t-shirts available for first 30 registrants. Mail registration and checks to 105 Eden Street,
Bar Harbor, ME 04609 before June 20th, or register at the Graham Lake Dam starting at noon
on race day.
Available Classes: Check off your desired class
K1-M Single Men's kayak
K1-W Single Women's kayak
OC-1M Solo Men's open canoe
OC-1W Solo Women's open canoe
OC-2M Tandem Men's open canoe
OC-2W Tandem Women's open canoe
OC-2X Mixed open canoe
Other:

Partner name, if applicable: ______________________________________

I, the undersigned, certify that I agree to abide by the rules of the race as well as the instructions and directives of the race
officials. I recognize the inherent danger of whitewater paddling and will not race if, after inspection of the race course, it is
determined to be beyond my capabilities as a whitewater paddler. I agree to hold harmless from liability for injuries to my
person or property the sponsoring organizations, officials, safety volunteers, and landowners, and realize that it is not
incumbent upon them to furnish first aid, rescue, or salvage equipment and personnel.

___________________________________________ ___________________________________________
(Signature of Paddler) (Parent or Guardian’s Signature if Paddler is under 18yrs. old)

DATE:__________________ Emergency Contact Info: Name______________________________ Phone_______________

Contact Tammy Kelly at 667-3947 or TammyKwh2ow@hotmail.com for more information. You can also contact the URWC
office at 288-2944 x424 or thussey@coa.edu.