Nathan Benderson Park Dragon Boat 101 Registration
Please complete the registration below. Follow the payment instructions at the bottom of the page.
Participant First Name
Participant Last Name
October: 10/7, 10/14, 10/21, 10/28
January: 1/6, 1/13, 1/20, 1/27
April 4/7, 4/14, 4/21, 4/28
Class Start Date
Please enter the date of the first class of the session you have chosen
Cell Phone #
Date of Birth
Emergency Contact Name
If the participant is under the age of 18, please enter the parent or guardian's name
Emergency Contact Phone #
Allergies or Medical Conditions
Please enter N/A if not applicable
Can you swim?
Are you interested in volunteering at Nathan Benderson Park?
How did you hear about the course?
Please click the submit button below. You will be directed to PayPal to complete your payment.
You will receive an email confirming your registration as well as additional information about the course.
Please be sure to keep an eye on your spam email to avoid possibly missing important information.
If you have any questions please do not hesitate to email firstname.lastname@example.org
Send me a copy of my responses
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