Pre-Registration Form
Fourth Annual Pamlico Paddle--May 13, 2000
Name(s)_______________________________________________________________________
Address_______________________________________________________________________
Telephone_____________________________________________________________________
e-mail address__________________________________________________________________
# of people in party_________
# of boats in races: Canoe________ Sheltered Kayak________ Advanced Kayak_______
Paddling Experience: Beginner______ Intermediate______ Advanced______
# of people having lunch_______
Registration fee: ($10 per paddler, includes T-Shirt)__________
Lunch fee: ($6 per person)__________ Total enclosed:__________
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Please read the following and sign:
I (Print)_______________________________voluntarily assume any and all risks of participation in The Third Annual Pamlico Paddle. I hereby release and agree to hold harmless any organizers and sponsors of this event from any liabilities, claims, and damages, whether caused by any negligent act or omission of the organizers and sponsors, or volunteers, or from any cause whatsoever. I will further insure that all members of my party participating wear an approved life-jacket while on the water and that each boat under my charge will carry an audible signaling device.
Signed:_______________________________________________________
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Make checks payable to: Pamlico County RDP.
Mail your registration to: John Hinners, 58 Lauren Drive, Merritt NC 28556
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