Club Race Nomination

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* 1. Which Race are you entering a team into

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* 2. Which Gender?

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* 3. Which Race Category?

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* 4. Which Event/Course Type?

OC6 Seniors LONG 12km (Men/Women/Mixed)

OC6 16U, 19U & Seniors SHORT 8km (MIXED ONLY)

OC6 Mighty Minnows (3 Minnows and 3 12Us OR 3 x Minnows, 2 x 12U with 1 Adult Steerer)

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* 5. Team Name

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* 6. Team Member Names

Paddler 1

Paddler 2

Paddler 3

Paddler 4

Paddler 5

Paddler 6

Reserve

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* 7. Amount Paid to Club Account

$120 Senior Team

$60 Junior Team

$5 p/p Canoe Towage

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* 8. Date amount paid and by whom

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* 9. Team Manager/Contact details

Name

Phone Number