CANOE COURSE BOOKING FORM PERSONAL INFORMATION Name * Prénom Nom de famille Age * Pronoun used * She / He / They / Other Height * Weight * Email * Address * Adresse 1 Adresse 2 Ville Région/Province Code postal Pays Phone * (###) ### #### Allergies * If yes, please specify Health insurance number * Expiry * MM JJ AAAA Name of emergency contact * Relationship * Phone number of contact in case of emergency * (###) ### #### Language spoken * English French Both Canoeing experience * No experience in a canoe Beginner flat water Intermediate/Advanced flat water Beginner whitewater Intermediate whitewater Swimmer level * Don't know how to swim Comfortable in the water Good swimmer Specific goals for this canoe course? * How did you hear about us? * Family Friends Internet Facebook Instagram Other If other, how? Canoe Course dates * Saguenay May 6-7 2023 Saguenay May 20-21 2023 Saguenay June 3-4 2023 Saguenay June 17-18 2023 Saguenay September 2-3 2023 Saguenay September 9-10 2023 Gatineau May 13-14 2023 Gatineau June 25-26 2023 Gatineau July 8-9 2023 Gatineau August 19-20 2023 Instructor course May 26-29 2023 Thank you!
