Name *

First Name

Last Name

Phone *

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Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone *

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What are you most interested in learning about?

Please choose all that apply.

Proper paddling technique (basic strokes and maneuvers)

Understanding local water levels (outflow from Kinzua Dam and local creeks, what it means, how to monitor from home, etc)

Controlled capsize / wet exit

DNA of a River (natural + man-made hazards)

Advanced safety equipment (throw ropes, tow ropes, etc)

Our watershed

Swimming the boat to shore (short distance)

Paddle signals

Re-entry after capsize

Advanced strokes and maneuvers

Wind, weather, waves, water (thunderstorms, battling the elements, etc.)

Kayak carries

Loading/Unloading kayaks from vehicle

Launching/Landing from land and docks

Essential Eligibility Criteria (EEC): ACA courses are open to all individuals who acknowledge the ability to perform the following essential eligibility criteria. *

• Breathe independently (i.e., not require medical devices to sustain breathing) • Independently maintain sealed airway passages while under water • Independently hold head upright without neck / head support • Manage personal care independently or with assistance of a companion • Manage personal mobility independently or with a reasonable amount of assistance • Follow instructions and effectively communicate independently or with assistance of a companion • Independently turn from face-down to face-up and remain floating face up while wearing a properly fitted life jacket* • Get on / off or in / out of a paddlecraft independently or with a reasonable amount of assistance • Independently get out and from under a capsized paddlecraft • Remount or reenter the paddlecraft following deep water capsize independently or with a reasonable amount of assistance • Maintain a safe body position while attempting skills, activities and rescues listed in the appropriate Course Outline, and have the ability to recognize and identify to others when such efforts would be unsafe given your personal situation

I have the ability to perform the above essential eligibility criteria.