Kayaking Questionnaire

Kayaking Questionnaire (Whitewater Kayaking School)

Please take a moment to completely fill out this questionnaire. This information will help the staff to properly outfit you and your needs during your instructional classes with us. This information is kept private and confidential and will not be shared outside our staff. All members of your party need to fill out their own questionnaire.

Trip Info
Trip Name*
Trip Date*
MM slash DD slash YYYY
Your Name*
Email*
Phone*
Address
Street Address Address Line 2 City State ZIP Code
Birthdate*
MM slash DD slash YYYY
Sizing Info

Please be as accurate as possible for your own comfort.
Height
Weight
Inseam
Waist
Foot Size
Pertinent Past & Present Medical History

Please be completely truthful when filling out this section and be sure to list anything that we may need to know if an emergency should arise.
Allergies
Medications
Medical Conditions
Emergency Contact Information

Please be completely truthful when filling out this section and be sure to list anything that we may need to know if an emergency should arise.
Contact Name*
Contact Day Phone*
Contact Cell Phone*
Relationship
Equipment

NMRA provides all the necessary equipment for your kayaking classes. However, if you have personal equipment that you would like to bring along you are more than welcome to do so.
Is there anything else you think we should know about you?
How did you hear about us?

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Kayaking Questionnaire

Trip Info

Sizing Info

Pertinent Past & Present Medical History

Emergency Contact Information

Equipment

NMRA provides all the necessary equipment for your kayaking classes. However, if you have personal equipment that you would like to bring along you are more than welcome to do so.