2021 Kiptopeke Sea Kayaking Symposium Registration
Please complete all registration information, including the health/medical information. See website or the course listings I sent for full class descriptions.
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Email *
Glad you want to join us!!
First Name, Last Name - put your answer in the space below (short answer text) *
Street address - do not write here; put answer in space below *
City. State Zip code *
Preferred Phone Number *
Enter the phone number you prefer us to use if we need to contact you (i. e. cell or home or work)
email address *
Gender *
Age *
ACA membership *
Please indicate whether you are a current ACA member.
ACA Membership number (if not a member enter n/a) *
Bonus Course: British Canoeing Sea Leader (formerly 4*) Training with Todd Wright *
Check "yes" if you want to register for the BC Sea Leader training that will take place in the two days immediately prior to the Symposium i.e., Weds and Thurs Sept 15 - 16.
Regular Symposium Courses
Following are the symposium courses for each day (ignore right below here where it says "short answer text")
Choice of classes for Friday 17 September
Check which class is your FIRST choice for Friday. If you want to do separate classes for the morning and afternoon, tick both classes. See website for full course descriptions.
Choice of classes for Saturday 18 September
Check which class is your FIRST choice for SATURDAY. If you want to do separate morning and afternoon sessions, tick both boxes
Choice of classes for Sunday 19 September
Check which class is your FIRST choice for SUNDAY. If you want to do separate morning and afternoon classes, tick both classes.
Symposium Housing: House size
Shared room - if applicable, indicate who you want to share a room with. If no preference, enter "none" *
Shared house - if there are people that you would like to have in the same house as you, enter their names (but no guarantees). If no preference or if staying elsewhere, enter "none" *
Food Preference (for the Saturday dinner)
Clear selection
Medical/Heath Information. We really need to know if you have any medical/health issues. This information will be kept confidential. Please check any and all relevant boxes below if you have the indicated health problem or condition. Checking a box means "yes", you have that problem. If you don't have the problem leave the box blank. If you have any of these health/medical issues, please describe the problem in the text box at the end of this section. If you don't have any of these problems check "none" *
Medical/Health - please elaborate on any problems identified above
Make/model of kayak you'll be bringing *
Registration Type and Cost *
Please check the type of registration you want. If "Full Symposium", you don't need to tick anything else unless: 1) you want to stay over Sunday night in the lodge and/or 2) you need to pay the ACA insurance fee for non-ACA members. If you want the "Symposium Only", the only other thing you may need to check is the ACA Insurance fee for non-ACA members. If you are registering for ala carte classes, tick Saturday dinner if you want that and/or the ACA insurance fee if you are not an ACA member.
Total Due *
Add up the amounts for the boxes you checked above and indicate below the total amount you will be paying. Use Zelle and send to rwiebush@gmail.com. Or pay by check. Make checks payable to Cross Currents Sea Kayaking. Mail your check to: Cross Currents Sea Kayaking 123 Osborne Ave. Baltimore, MD 21228
That's it. Thanks. We will: 1) confirm your registration as soon as possible (could be a few weeks) and then 2) provide class selection and housing information via email after we have received your check.
You can use the text box below to provide any additional information or to ask any questions you may have.
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