Brew Dash Registration - 2023 - Whitewater Center

How many people would you like to register?*

Name*

First Last

Gender*

Male

Female

Age*

Phone*

Email*

Address*

Street Address City State ZIP Code

Emergency Contact*

First Last

Emergency Contact Phone*

Select your distance:*

T-shirt Size*

Hidden

Would you like to add-on a pair of Brew Dash Socks for $14 + tax?*

Yes

No

What is your sock size?*

Sub-Total

Name*

First Last

Gender*

Male

Female

Age*

Phone*

Email*

Address*

Street Address City State ZIP Code

Emergency Contact*

First Last

Emergency Contact Phone*

Select your distance:*

T-shirt Size*

Hidden

Would you like to add-on a pair of Brew Dash Socks for $14 + tax?*

Yes

No

What is your sock size?*

Sub-Total

Name*

First Last

Gender*

Male

Female

Age*

Phone*

Email*

Address*

Street Address City State ZIP Code

Emergency Contact*

First Last

Emergency Contact Phone*

Select your distance:*

T-shirt Size*

Hidden

Would you like to add-on a pair of Brew Dash Socks for $14 + tax?*

Yes

No

What is your sock size?*

Sub-Total

Name*

First Last

Gender*

Male

Female

Age*

Phone*

Email*

Address*

Street Address City State ZIP Code

Emergency Contact*

First Last

Emergency Contact Phone*

Select your distance:*

T-shirt Size*

Hidden

Would you like to add-on a pair of Brew Dash Socks for $14 + tax?*

Yes

No

What is your sock size?*

Sub-Total

I understand that race shirts are only guaranteed to those who register on or before June 5th, 2023.*

I understand

I understand in order to receive my post race beer I will need to present a valid form of identification showing that I am 21+ as of June 17, 2023.*

I understand

I have read and understand the U.S. National Whitewater Center's Assumption or Risk, Release, and Indemnity Agreement.*

I understand

Assumption of Risk, Release, and Indemnity Agreement

I understand the Whitewater Race Series Refund and Transfer Policy.*

I understand

Race Policies and Information

Sub-Total

Credit Card*

Card Details

Cardholder Name

Billing Address*

Same as Participant 1

Street Address City State ZIP Code

Total

Promo Code

Brew Dash Registration – 2023