Chattahoochee Riverkeeper - 2013 Back to the Chattahoochee River Race & Festival

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6/10/13

Chattahoochee Riverkeeper - 2013 Back to the Chattahoochee River Race & Festival CALL US AT 404-352-9828 OR CONTACT A STAFF MEMBER DIRECTLY

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Confirmation #: 20132901E422 Status: Payment Due Registered Date:6/10/2013 3:13:40 PM ET 2013 Back to the Chattahoochee River Race & Festival

REGISTRATION: The entry fee for solo boats is $40 and $60 for tandem boats (two people). Race entries are limited. We strongly suggest registering as soon as possible to ensure admission. On site registration will only be available if capacity is not reached in advance. All "registered paddlers" will receive a gift bag, a race T-shirt, and a boxed lunch. Your registration includes a complimentary one-year membership with the Chattahoochee Riverkeeper. A FEW OTHER DETAILS... Participants must provide their own craft, Personal Flotation Devices (PFDs), and paddle. All racers must pass an equipment inspection the morning of the race. Youth age requirements to race: If paddling solo, paddler must be at least 15 years old. If paddling tandem, youth must be at least 8 years of age and accompanied by an adult at least 21 years of age. No "passengers" under 5 years of age. If you need to rent your equipment, CLICK HERE to view a listing of local outfitters. Additional details will be provided in your confirmation email. Have you read the CRK Liability Waiver and agree to the terms? Yes PADDLER INFORMATION First Name Kenneth Last Name Kvasnicka Email Address (a confirmation email will be sent to this address) [email protected] Address Line 1 5733 Revington Dr Address Line 2 City Norcross State Georgia Zip 30092 Primary Telephone: (999) 999-9999 678-772-5381 Are you a current CRK Member? Yes Gender Male

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6/10/13

Chattahoochee Riverkeeper - 2013 Back to the Chattahoochee River Race & Festival

Male Age 55 Age Group Adult Category: Over 16 years of age T-Shirt Size (adult sizes only) L Meal Choice Meat Please specify any ADA/Special Needs

Please provide emergency contact information that will be available the day of the event. Emergency Contact Amy Kvasnicka Emergency Phone 678.643.8189 TANDEM PADDLER INFORMATION YOUR TANDEM PARTNER MUST REGISTER SEPARATELY - $30 each. Please enter your tandem partners name below so we can match you up. First Name Mark Last Name Kvasnicka RACE CATEGORIES NEW! Both Open and Recreational paddlers will paddle an 8 MILE race - ending at Riverside Park. Select your Race Category Recreational Number of Paddlers Tandem Type of Boat Canoe Canoe Division (no double bladded paddles allow in this category) Recreational - under 17'6 (comprised of materials other than carbon fiber, Kevlar, or fiberglass) Select if you wish to participate in the Best Costume and/or Best Boat Decoration Note: judging for the best costume/best decoration will be held before the race starts. Do you wish to participate in the Team Challenge? Yes Name of Team MWHK Share Your Race Experience How many years have you participated in the River Race? 3 Please share your experiences or general comments. First timers - we'll ask this of you next year! Always a great time . . . And a nice way to start the weekend. PAYMENT INFORMATION Please enter your credit card billing address below if different than your contact address. Otherwise select "Use same address for billing information" to prepopulate billing address fields.

Payment Information Payment Number: 1 Check Fees $ 30.00 Collected : $ 0.00 : Check/Money Order Number # Kenneth Kvasnicka 5733 Revington Dr Norcross GA, 30092 Balance:$ 30.00

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6/10/13

Chattahoochee Riverkeeper - 2013 Back to the Chattahoochee River Race & Festival

Copyright © 2009 Upper Chattahoochee Riverkeeper. All rights reserved. Photography courtesy of Joe Cook, Monica Cook, Adrian Fusinaz, Kent Ruby, Bard Wrisley and Tom Wilson Logo and Graphic support courtesy of Donahue Studios, Inc.

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