A p p l i c a t i o n
for the 2012 Delaware & Raritan Canal Paddlers' Race
Advanced registration is required
Name and
Address
City
State ZIP
Phone
Email
Address
City
State ZIP
Phone
Email
Register Before September 1st and get a 20% discount!
Before October 1st get a 15% discount! Before November 1st 10% discount

Solo $ Tandem $

Canoe Kayak male female mixed The color of my boat is  
I am a with an expected elapsed time of:
I will be wearing a PFD    I will wear a paddling or bicycle helmut

Only available at this race: Request your start time:

Notice that the heats are ONLY 6 minutes apart

10:00 10:06 10:12 10:18 10:24 10:30 10:36 10:42

Click to see current Start times in another window.

Additional comments

Mail this with
your check
payable to:

"Meadows Foundation"
c/o Carol Sas
80 Winston Drive
Somerset, NJ 08873

The Meadows Foundation and the Blackwells Mills canal group are working hard at getting them working.

Delaware & Raritan Canal Paddlers' Race
RELEASE
In consideration of being entered in this race, I the undersigned intend to be legally bond hereby for myself, my heirs, executors, and administrators, wave and release the Meadows Foundation, race supervisors, volunteers, D&R Canal Commission , State of New Jersey and sponsors for any and all injuries suffered by me in this event. I attest and verify that I am physically fit, and sufficiently trained for the completion of this event. I hereby grant full permission to any and all of the foregoing to use any photographs, video tapes, motion pictures, or any other recording or any other record of this event for any legitimate purpose.

Signed _________________________________ Date ___________

Print Name: _________________________________


Signed _________________________________ Date ___________

Print Name: _________________________________