Savannah Canoe and Kayak

SURF JAM 2011 REGISTRATION FORM

SATURDAY, OCTOBER 29, 2011

Check In at 8:00am – COST $50.00

Meet at 18th Street Beach Access, Tybee Island at 8:00am. PFD and helmets required for all participants. Bring water and clothing/supplies for a full day on the beach. Lunch will be provided. Award ceremony at Huc A Poos at 5:00pm. Three day cancellation policy for a full refund.

NAME:

CELL PHONE NUMBER:

ADDRESS:

EMAIL:

METHOD OF PAYMENT: CASH ________ CHECK ________ CREDIT CARD ________

CC#____________________________________________________________________________

Expiration Date: ________________   Security Code: __________________

* Make checks payable to: Savannah Canoe and Kayak

* Mail applications to: Savannah Canoe and Kayak 414 Bonaventure Rd., Savannah, GA 31404

* Registration Deadline: October 25th, 2011

CATEGORIES: (Choose up to 2)

LOSERS  ___________

SIT ON TOP TANDEM  __________

WOMEN’S OPEN  __________

SEA KAYAK  __________

MEN’S OPEN  __________

Tandem Partner Needed? Yes / No     (Sit On Top Tandems Provided.)

Other Gear or Boats Needed? Yes / No

Please Explain _____________________________________________________________________

912.341.9502

www.savannahcanoeandkayak.com