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Here's an easy way to sign up. As you fill in your information, consider whether this trip is right
for you. When finished, just click send. If your friend
wants to come with you, s/he must also open this questionnaire and fill it out to reserve a spot.
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| Can you swim? |
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| I stay in shape by ? |
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| Within the last 5 years I have canoed ... |
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| My present paddling skills include ... |
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| Please share any special physical conditions that might affect your ability to
complete this outing: |
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Your medical information will be deleted after completion of the trip. |
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Emergency Contact:
Phone (###-###-####):
Allergies / reaction / medication:
Other medications:
Had a tetanus shot within 10 yrs?
Have or had ... |
, relationship:
Home: Cell:
Asthma , Diabetes , High Blood Pressure |
| Do you own a canoe or kayak you want to bring? If so, how long and what type? |
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| Would you like to carpool? If you are driving, how many people could car pool
with you? |
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| If the WI River levels are unsafe, what would you prefer? Hold down <ctrl> key and
click all you would like. How many miles do you enjoy hiking daily? |
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| Type any questions or concerns you have here: |
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| Name: |
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| E-mail (a copy of your responses will be e-mailed to you): |
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| Address: |
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| City: |
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| Zip Code : |
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| Phone (###-###-####): |
Home: Cell: |
| Please add me to the Woods & Wetlands Outings e-mailing list: |
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| Please include my e-mail address or phone # on the roster web page for
carpooling: |
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