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Membership Registration

To create your account please enter your information in the form below. Fields with an astrisk are required.

Primary Household Member ($10.00 registration fee)
* Household Name:  
* Email Address:
* First Name:  
* Last Name:  
* Address:  
* City:  
* State:  
* Zip:  
* Day Phone:  
Evening Phone:
*   Do you have any secondary household member(s) that would like to register?   
* UserName:  
* Password:  
* Confirm Password:    
River Preferences
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Inflatable Kayak    Open Canoe   
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Sea Kayak    Other   
Membership Preferences
* Would you like to subscribe to our listserv?
* Would you to subscribe to our Monthly Newsletter?
* Would you like to be included in our Member/Phone directory?

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