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Maui to Molokai Race Camp April 2012
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Paddler Information
Today's Date (dd-mm-yyyy)
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Name
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First
Last
Date Of Birth (dd-mm-yyyy)
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Sex
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female
male
Address
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Line 1
Line 2
City
State
Zip Code
Country
Email
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Phone Number (primary)
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-
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Phone Number (secondary)
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-
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Paddling Information
Which of our camps are you interested in attending?
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Maui Downwind Camp February 22-26, 2012
Maui Women's Only Downwind Camp, April 6-10, 2012
Maui to Molokai Race Prep Camp, April 23-28, 2012
Do you have any medical conditions that we should be aware of?
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How long have you been involved in paddling outrigger/surfski
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What major events have you participated in recently? (last 2 years)
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Please briefly describe your current weekly workout schedule (number, type, duration of workouts)
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Are you able to swim 500 meters?
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Yes
No
Are you able to tread water for 30 minutes?
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yes
no
Unisex Shirt Size
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xs
s
m
l
xl
xxl
Emergency Contact Information
Name
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First
Last
Relationship
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Phone Number (primary)
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-
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Phone Number (secondary)
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-
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Submit