Girl Scout Canoe Paddlesports Safety Facilitator Certification Course Registration

Please complete the below form to register for the ICW on 23 April 2017. Mandatory fields are marked with an asterisk (*).

Phone *
Phone
Birthdate *
Birthdate
CKAPCO uses this information to select appropriate equipment for students.
CKAPCO uses this information to select appropriate equipment for students.
Add me to CKAPCO's e-mail list? *