SWR NP

Swift Water Rescue

ACA Level 4 Swift Water Rescue Course
Location: Ocoee, TN on the Ocoee River
Date: August 18-20, 2017
School Fee: $85.00

Registration deadline: August 11, 2017
Late Registration: +$20; students admitted at instructor discretion

YOUR REGISTRATION FEE INCLUDES:

1. Professional quality training in basic river rescue techniques over two days.
2. Two nights in the bunkhouse at Ocoee River Rats. Bring your own sleeping bag/gear.
3. Dinner Saturday evening.

TSRA Membership Required
**If you are not a member you can join below on this form.

Time:   Friday from 7:00pm to 9:00pm (river knots practice)
             Saturday from 8:00am to 6:00pm
             Sunday from 8:00am to 5:00pm
Note:   We will camp together as a group while instruction is ongoing.

The cancellation policy for the course is:
- If TSRA cancels class, for any reason: Full refund.
- Until one week prior to class: full refund minus $10.00 fee.
- One week until class start: full refund minus $10.00 fee if substitute student is found . Otherwise NO REFUND (regardless of reason for cancelation). Money will be refunded only after substitute pays for registration.
- After class starts: NO REFUND
WANT TO REGISTER MORE THAN ONE STUDENT? No problem!
If you would like to register and pay for more than one student you may do so. However, please include their contact email address so we can reach them with further class details and have them sign our online waiver. Thank you!
How many students do you want to register/pay for? *
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Student Information:
Student Name: *

First Name Last Name
Email: *
Phone: *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Are you a member of the American Canoe Association? If so, please tell us your ACA number as this will help TSRA save money on insurance.
Your ACA number if you have one:
(Keep this number handy for the next screen.)
Emergency Contact Information:
Name and relationship: *
Contact's phone (cell): *
Contact's phone (day):
Contact's phone (evening):
Paddling Information
Please list swiftwater rescue courses previously taken:
Please list paddling courses you have taken:
Please list medical conditions we need to know about:
Second Student's Information
Student Name: *

First Name Last Name
Email: *
Phone: *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Are you a member of the American Canoe Association? If so, please tell us your ACA number as this will help TSRA save money on insurance.
Your ACA number if you have one:
(Keep this number handy for the next screen.)
Emergency Contact Information:
Name and relationship: *
Contact's phone (cell): *
Contact's phone (day):
Contact's phone (evening):
Paddling Information
Please list swiftwater rescue courses previously taken:
Please list paddling courses you have taken:
Please list medical conditions we need to know about:
Third Student's Information
Student Name: *

First Name Last Name
Email: *
Phone: *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Are you a member of the American Canoe Association? If so, please tell us your ACA number as this will help TSRA save money on insurance.
Your ACA number if you have one:
(Keep this number handy for the next screen.)
Emergency Contact Information:
Name and relationship: *
Contact's phone (cell): *
Contact's phone (day):
Contact's phone (evening):
Paddling Information
Please list swiftwater rescue courses previously taken:
Please list paddling courses you have taken:
Please list medical conditions we need to know about:
Fourth Student's Information
Student Name: *

First Name Last Name
Email: *
Phone: *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Are you a member of the American Canoe Association? If so, please tell us your ACA number as this will help TSRA save money on insurance.
Your ACA number if you have one:
(Keep this number handy for the next screen.)
Emergency Contact Information:
Name and relationship: *
Contact's phone (cell): *
Contact's phone (day):
Contact's phone (evening):
Paddling Information
Please list swiftwater rescue courses previously taken:
Please list paddling courses you have taken:
Please list medical conditions we need to know about:
Fifth Student's Information
Student Name: *

First Name Last Name
Email: *
Phone: *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Are you a member of the American Canoe Association? If so, please tell us your ACA number as this will help TSRA save money on insurance.
Your ACA number if you have one:
(Keep this number handy for the next screen.)
Emergency Contact Information:
Name and relationship: *
Contact's phone (cell): *
Contact's phone (day):
Contact's phone (evening):
Paddling Information
Please list swiftwater rescue courses previously taken:
Please list paddling courses you have taken:
Please list medical conditions we need to know about:
Sixth Student's Information
Student Name: *

First Name Last Name
Email: *
example@example.com
Phone: *

Area Code Phone Number
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country
Are you a member of the American Canoe Association? If so, please tell us your ACA number as this will help TSRA save money on insurance.
Your ACA number if you have one:
(Keep this number handy for the next screen.)
Emergency Contact Information:
Name and relationship: *
Contact's phone (cell): *
Contact's phone (day):
Contact's phone (evening):
Paddling Information
Please list swiftwater rescue courses previously taken:
Please list paddling courses you have taken:
Please list medical conditions we need to know about:
Are you a TSRA member? *
Payment Information
******We do not accept American Express*********
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Swift Water Rescue

Student Information:

Emergency Contact Information:

Paddling Information

Second Student's Information

Emergency Contact Information:

Paddling Information

Third Student's Information

Emergency Contact Information:

Paddling Information

Fourth Student's Information

Emergency Contact Information:

Paddling Information

Fifth Student's Information

Emergency Contact Information:

Paddling Information

Sixth Student's Information

Emergency Contact Information:

Paddling Information

Payment Information