SCORA

Paddler Registration

Registration is open only to current SCORA members.

Account Information

* Username:

More than 5 characters

* Password:

More than 5 characters

Paddler Information

* Person Registering:

I am over 18 and registering myself

I am a parent/guardian registering a minor under 18

* Club Affiliation:

* Paddler Type:

Personal Information

* First Name:

Middle Initial:

* Last Name:

* Birthday:

* Gender:

Male

Female

Contact Information

* Email Address:

* Email Confirm:

Retype your email to confirm it's accuracy

* Home Number:

Cell Number:

* Address:

Address 2:

* City:

* State:

* Zip Code:

Emergency Contact Information

* Contact Name:

* Home Number:

Cell Number:

Relationship:

Terms and Conditions

* I agree to the terms and conditions

Yes

Minor Waiver

In consideration of the minor (name listed above, "Minor") being permitted by SCORA to participate in its activities and to use its equipment and facilities, I further agree to indemnify and hold harmless SCORA from any and all Claimes which are brought by, or on behalf of Minor, and which are in any way connected with such use or participation by Minor.

Parent/Guardian Name:

I agree to all terms above on behalf of Minor

Yes

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