Information and Membership Form (2019)
Mahalo for paddling with Cayuga Outrigger Canoe Club!
Check out our website at http://CayugaOutrigger.com.
All guest paddlers and members must fill out this online form (which includes liability waiver) prior to paddling.
This online form should take about 5 minutes to complete.
Email address *
Personal Information
*Information provided below will be used by the Cayuga Outrigger Canoe Club (COCC), and only contact information will be available to current COCC members. The directory is for official club use only and personal information will not be sold or otherwise distributed.
Name *
Your answer
Name of parent/legal guardian (if participant is under the age of 18) who is authorizing the liability waiver
Your answer
Street address, City, State, Zip *
Your answer
Mobile phone number (or best number to reach you) *
Your answer
Birth year *
Your answer
Emergency contact information *
Name and cell number of someone not paddling with you
Your answer
Do you have any health conditions that could impair you and/or be aggravated by this sport? If yes, please describe them and how best to help you in case of emergency: *
Your answer
Swimming ability *
American Red Cross certifications *
Required
Do you have paddling experience?
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