Corrib Canoe Summer 2019
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Email *
Parent or Guardian Name (junior course only)
Number of people registering *
Name *
Name (registering second person)
Name (registering third person)
Name (registering fourth person
Age (minimum 8 years old)
Contact Number *
Email *
Address *
Date Of Course *
Course Time *
Any medical conditions we should be aware of? (if this does not apply please just type N/A) *
Are you comfortable in the water? *
If applicable what years did you previously attend Corrib Canoe
Method of payment for deposit *
How did you hear about Corrib Canoe Courses? *
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