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Taunton River Watershed Alliance with Canoe Passage Outfitters
Tuesday, August 8th (Rain Date Wednesday August 9th)
Full Moon Paddle Trip
Lake Nippenicket, Bridgewater
7:00 P.M.
PLEASE PRINT THIS FORM AND BRING FORM AND PAYMENT TO PUT-IN
RENTAL COST: $30/canoe or kayak
Call Canoe Passage at 1-800-689-7884
no later than Saturday, August 5th to reserve
a canoe or kayak.
If bringing your own boat, a donation to TRWA is requested.
Please Let Us Know if you are bringing your own boat!
Contact: Susan Speers
Toll-Free: 1-866-393-TRWA
Wearing of Personal Flotation device & extra paddle required;
Insect Repellent; Flashlight; Long Sleeves, Long Pants Suggested.
Youths under 18 years of age must be accompanied by an adult
No Alcohol Allowed on the Lake
COPY AND PASTE THE FORM BELOW INTO A NEW DOCUMENT
OR PRINT THIS WINDOW FROM YOUR BROWSER
Paddler #1: (Please Print!)
Name: _____________________________________
Address: ___________________________________
___________________________________
Phone: _______________________
TRWA Member? ____ Yes ____ No
Paddler #2: (Please Print!)
Name: _____________________________________
Address: __________________________________
___________________________________
Phone: _______________________
TRWA Member? ____ Yes _____ No
I/We the undersigned, hereby release the Taunton River Watershed Alliance and Canoe Passage Outfitters, their officers and members, from responsibility for any injury and/or loss of equipment incurred by me/us while participating in this event and agree to assume all responsibility for any injury or loss.
___________________________________
Signature – Paddler #1
___________________________________
Signature – Paddler #2
Consent and Agreement to the above release for above participants under 18 years of age:
Parent/Guardian Sign Here:
_______________________________________________________
If more than two will be in your party, please make additional copies as needed.
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