Name:  Age:
Street:
City:     State:  Zip: 
Home phone: fax: 
Work phone:
fax: 
e-mail:


Trip Choice:
  Activity name:
Activity date:
  Cost: $210. 
Will you be using your own boat?   Yes      No
If you are with a group, the name of the group:

Payment method: check in the amount of: $ check#:
                           M/C or VISA:
- - -   **Security Code______

           *** 3 Digit Security Code is found on the back of the card by the signature line**
                           exp. date:
/ Signature:  

Two to three days before your trip you will receive a letter from Adventure Challenge containing a confirmation and additional information concerning your trip. The information will include directions to the departing point and suggestions on what to bring. Thank you and we look forward to serving you.

Reservation/Cancellation Policy:  Our policy is that we do not offer any refunds after 1 week prior to any trip.  Our policy is necessary to hire guides, reserve equipment, and purchase supplies for your trip.  Additionally our trips are limited in size and a registration/payment is a commitment for space on a trip.
 
When people call with a reason not to keep their commitment we are not in a position to follow up on each of them to determine what is genuine and what is not, so we have found having a consistent policy that is disclosed upfront has been fair to both our customers and ourselves.

Waiver, Discharge, and Release:  Even though the whitewater industry has a good safety record, there are inherent elements of danger beyond our control. You are asked to assume responsibility for many decisions for yourself. There is a risk of property loss, personal injury, and/or death in any waterborne event or activity. You must sign a release prior to participating and go at your own risk. All minors must have a release signed by the custodial parent or legal guardian. In the event the child will not be accompanied by the parent, the release needs to be mailed in advance.

Please mail or email this registration form with payment to:
Adventure Challenge
, 8225 Oxer Rd, Richmond, VA 23235
ph: (804) 276-7600: e-mail: info@adventurechallenge.com
To email: First, scroll your screen so that the information you typed on this form is visible on your computer screen.  This process only captures what you can see on your screen.  Simply press and hold the "Alt" key then press the "Prt Scrn" key, this will copy the visible part of the web page to your clipboard.  Then paste it in to the body of an email and send it to us.  We look forward to spending the day kayaking with you!