PDBC 2017 Registration Form
Registration Form for Academy, BMO, Competitive and Youth programs
First Name *
Your answer
Last Name *
Your answer
Email Address *
Your answer
Phone Number *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Street Address *
Your answer
Gender *
Emergency Contact Name *
Your answer
Emergency Contact Number *
Your answer
Which program are you registering for? *
Paddling Side *
Paddling Division Based on Age (Competitive Registrants Only)
Desired Academy Program (Academy Registrants Only)
Regatta Attendance (Please check off all regattas you will be attending) *
Required
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