First Name * Last Name * Email Address * The program reminder and/or virtual link will be sent to this email address. Mailing Address City, State Zip Code * If others are attending with you, please list their names below: Where did you hear about this program? * Portage Park District newsletter Portage Park District website Park kiosk Facebook Instagram Park staff Word of mouth Other Are you currently on our mailing list? * Yes No Would you like to be added to our mailing list? * Yes No Photo and Video Waiver option * Often we take photos or videos at our events and programs to use in future publications. Use the yes or no buttons to let Portage Park District know if you agree to the photo and video consent. Photo and video consent: I agree to allow publication of any photo/media for future park district programming. Yes No Correct Registration * Yes I understand that by filling out this registration form, I am responsible for bringing my own watercraft, personal flotation device, and paddles. If you don't have these things, you will need to register through KSU's link. https://www.kent.edu/recwell/adventure-trips Leave this field blank
