2004 Wildwater Race Entry Form
Antietam Creek Downriver Race - Saturday, April 10
(Please circle race you are entering, thanks!)
Little Falls Wildwater Race - Sunday, April 25
EVENT: _____________________________________________
DATE: _____________ CLASS __________________
DATE OF BIRTH: ____________
NAME: _____________________________________________
ADDRESS: ____________________________________________
CITY: ___________________ ZIP CODE: _______________
PHONE NO.: __________________________________________
E-MAIL ADDRESS: ____________________________________
USA Canoe Kayak Number _______________
USACK WAIVERS MUST BE SIGNED RACE DAY. Racers under 18 need the signature of their parent or legal guardian to participate. FORMS WILL BE PROVIDED.
RACE FEE: $ __________
USACK insurance fee for non-members add $15.00
TOTAL: $ ___________
MAKE CHECKS PAYABLE TO “BCE”.
Mail entry form & fees to: Bob Bofinger
7209 Drummine Road
New Market, MD 21774
Contact information: Geoff Calhoun GCalhoun9[at]hotmail[dot]com 301-320-3846
Bob Bofinger CanoaBob58[at]aol[dot]com 301-865-8183
