Address ___________________________________

City, State,Zip_______________________________

E-Mail ______________________

T-shirt Size M L XL XXL (circle one, 150 Challengers only)
(tandem teams please fill in both sections)

Name ___________________________________

Address ___________________________________

City, State,Zip_______________________________

E-Mail ______________________

T-shirt Size  M L XL XXL (circle one, 150 Challengers only)

Bushwhacker Sprint $10 entry fee per paddler

solo ___tandem___

Bushwhacker Cruise $50 entry fee per paddler

solo ___tandem___

Halfwhacker $75 entry fee per paddler
solo___ tandem___

solo ___tandem___

Halfwhacker $75 entry fee per paddler
solo___ tandem___

Bushwhacker 150 $150 entry fee per paddler

solo___ tandem___

expedition class____ marathon class ___

Total Amount Enclosed __________________