Registration and Waiver Form

Name

Age

Address

Email Address

Phone Number

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Please indicate number and watercraft preference, based on a first come first serve basis.

 

Watercraft

Credit Card Number

CC exp date

CC ID Number

Cash

____Canoe(s) @$50 ea.

 

 

 

 

____Single Kayak(s) @$50 ea.

 

 

 

 

____Double Kayak(s) @$50 ea.

 

 

 

 

____Personal watercraft(s) @$50 ea.

 

 

 

 

 

Total

 

 
             


What you need to know!

 All race participants must be pre-registered and paid in full (by credit card or cash only) prior to Thursday, September 4th.  Race day sign-in begins at 8:00am Saturday, September 6th at Gruff’s Tap & Grill (352) 465-2881.

                19773 E Pennsylvania Ave.

                Dunnellon, FL 34432

The 8 mile race shotgun is at 9:00am, with heats to be determined. All event rules will be strictly enforced. Participants must be 18 years or older. No food or drinks allowed in disposable containers on the Rainbow River per County Ordinance 85-17, 94-4. If you can throw it away, don’t bring it! Water and re-useable sports bottles will be provided. Volunteers will be at various locations along the river to refill beverage thermoses and sport bottles. Snacks and beverages should be in Tupperware-type containers. Volunteers will be at various locations along the river to refill beverage thermoses. Personal watercraft permitted must be a canoe, single kayak, or double kayak. Donated kayaks, canoes and gear are limited; pre-registration is on a first come first serve basis. First place prizes will be awarded in the single kayak category and double kayak category. Family fun day including games, food, & prizes will be held to announce winners will be held at Gruff’s during & after the race so bring your chair and come relax for a day of fun!

As A participant in the Kayak for a Cause charity event, I, for heirs, administrators, and myself assume any and all risks which might be associated with this event. I waive and release any and all rights and claims for damages which I may have against the organizers and others connected with this event, their representatives, successors, and signs for any and all injuries or damages of any kind whatsoever suffered by me as a resulted taking part in this event and related activities.

 

Participant Signature:______________________________                    Date:_____________

 

 

For more information please call (352)489-7854, email cherio84@msn.com or visit RainbowRiverCanoeandKayak.com.