Individual Registration

Interested in Paddling but can't organize an entire team? Secure YOUR SPOT on a Racing Team NOW!

Individual Registration Form
Please fill out the following information and the Waiver form.
Name
FirstLast
Address
Street AddressAddress Line 2CityState / Province / RegionZIP / Postal CodeCountry
Email
Phone
Gender*
- Male
- Female
Age*
- Under 18
- 18-24
- 25-34
- 35-44
- 45-54
- 55-64
- 65 or Above

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FEE: $35.00

Click here to DOWNLOAD the Registration form.
(Please come back for the ONLINE WAIVER FORM)

Mail out the Registration form and Waiver form and check to:

Port Jefferson Chamber of Commerce – Dragon Race Festival
118 West Broadway
Port Jefferson, NY 11777

Make the Check Payable to: PJ Chamber of Commerce
Credit Cards accepted.

Fee: $35.00

If there are enough individuals a full team will be formed.

Individual Registration Form