MAD YAKER'S REGISTRATION FORM
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Parent's Name_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Address_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ _ _
City/State/Zip_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _
Phone Number ( )_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ _ _ _ _ _ _ _ _ Email Address_ _
Child's Name_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ Child's Age_ _ _ _ _ Child's Height _ _ _ _ _ Child's Weight_ _ _ _ _ _
Camp Name
Mad Yaker's Flatwater camp (Wednesdays)_____ 3 Day Whitewater Camp____Mad Yaker's intro to River Kayaking (Friday)___ 5 Day-Overnight Whitewater Camp___
Mad Yaker's Intro to Whitewater (Fridays)___
Dates
____/____/____ to ____/____/____
Total Cost of Progam $__________
Total Amount Enclosed $________ please make checks payable to Clearwater Sports.
Visa/MC #_______________________________ Exp.__________
Reservations subject to availability and will be confirmed by Clearwater Sports.
Reservations made more than 30 days before a camp or activity require a 50% deposit. The balance is due 30 days before the start of your child's activity. Reservations made within 30 days require payment in full. If you cancel 30 days or more before the start of your child's activity you are entitled to a full refund less a $10 service fee. If you cancel within 30 days you will forfeit the cost of the trip. Upon receiving your deposit Clearwater Sports will forward an equipment list and medical forms.
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