Northwest Indiana Paddling Association Membership Form

If you are interested in joining the Paddling Club, please fill out this form or contact Dan Plath @ 11645 W. 50 N. Westville, IN 46391, Phone (219) 879-3084.

Please provide your Contact Information:

Name: ______

Address: ______

Phone # ______

E-Mail: ______

Which type of paddling do you typically do?

 Canoeing  Kayaking  Both  I don’t currently, but I am interested in joining

Where do you do most of your paddling? (Check all that apply)

 Great Lakes  Smaller InlandLakes  Whitewater  Rivers & Creeks Anywhere with H2O

Do you currently own a Canoe or Kayak?

 Yes  No

What Kind? ______

How would you rate your Paddling Skills?

 Advanced  Intermediate  Novice  Little to no experience, but would like to get involved

Are you a member of any other Paddling Club?

 Yes  No

(If yes, who?)______

Are you a member of any other conservation or civic organizations? ______

______

What interests you most & hope to accomplish through the paddling club?

(Please check all that apply)

Promoting Canoeing & Kayaking (ecotourism) in Northwest Indiana

Increasing Recreational Paddling Opportunities Throughout the Region

Supporting Ecological Conservation and Restoration Efforts

Increasing Public Access and Helping to Enhance Our Water Trails (log jam removal, beach & river cleanups, etc.)

Promoting Canoe & Kayak Knowledge and Safety

Advancing your Paddling Skills & Knowledge

Partnering on Projects with Other Paddling & Conservation Organizations

Supporting Environmental and Outdoor Recreation Educational Efforts

(Example: teaching kids how to canoe & kayak while learning about their surroundings)

Providing a Voice for Canoeists and Kayakers throughout the Region

Finding New Friends Interested in Canoeing and Kayaking

Getting out & having Fun Paddling our Wonderful Waterways!!!

Paddling Trips Outside of The Region

Other interests or ideas

______

Any special skills, abilities, interests, or ideas that you would like to share that could help the group? (Example: web design experience, teaching experience, ecological expertise, graphic arts, specialized trade, writing skills, etc.)

______

Which Current NWI Paddling Events are you most Interested In? (Check all that apply)

Michigan City Eco-Fit Challenge

 Trail Creek Fun Float

 The Marquette to BurnhamSea Kayak Expedition

Are you interested in serving on a paddling club committee?

 Yes  No  Maybe

For the newsletter, which do you prefer?

 An Electronic Copy

 A Paper Copy