Membership Application

Date

Month

Day

Year

Email*

Name*

Mailing Address

Phone #1*

Phone #2

Medical Certs

Other Certs

Other relevant training (Ropes, climbing, etc)

Class of WW you paddle

# years WW paddling

Craft

Please list the local rivers you have paddled at least 5 times

Provide detail your whitewater/swift water experience/accomplishments

Would you be willing to respond to a flat-water search?

Do you own a flat-water boat?

Is there anything else you would like to add?

Reference #1

Reference 1 Phone #

Reference #2

Reference 2 Phone #

Reference #3

Reference 3 Phone #

White Mountain Swiftwater Rescue