Petit Canoe Experience Application Form

Name of representative
Representative's email address
Mobile phone number of the representative
Desired Date of Experience　※Online reservations must be made two days in advance. If you would like to make a reservation the day before or on the day of, please call us instead (Japanese only).
Desired time
Gender of the representative	malefemaleother
Age of the Representative
the number of people
postal code
State/Province
Representative Address
Please provide the names, ages, and genders of those who are not represented in the program
Selecting a canoe (Adults are recommended to use a single-canoe.)	singletwo-seaterI'd like to discuss it with you.
Do any of the participants weigh more than 70 kg? (This information is required for canoe selection)	YesNo
How many of you are over 70 kg?(If you answered "Yes" above)
Other inquiries and communications

【What to wear, what to bring, and other information for the day (please be sure to check)】
(② and ③ can be borrowed for free)
①Clothing that is easy to move around in and dries easily when wet. Pants must be short or rolled up.
②Hat with chin strap
③Sandals or marine shoes (Crocs-like type with a band on the heel. Flip-flops and the like are not allowed as they can come off easily in the water)
④towel
⑤Drinks and sunscreen.
⑥A change of clothes for when it gets wet.
⑦When you go to the lodging facility "Kimimachizaka Ichinokura" next to Roadside Station Futatsui to take a bath on your way home, you can take a bath set.
⑧Masks (required for registration on land)
⑨A waterproof case for your phone and camera (with a string to hang it around your neck) if you want to take photos in a canoe.

【Notes (please agree to everything and check the box below to submit)】
1.Please follow your instructor's instructions during the experience.
（This is an experience in nature, so please do not act selfishly, as it can be dangerous!）
2.It is the participant's responsibility to take care of his or her valuables.
3.Junior high school students and younger must be accompanied by a parent or guardian, and minors must have the consent of a parent or guardian.
4.The experience may be cancelled due to weather or natural conditions.
5.You must be an Akita Prefecture resident who has not moved out of the prefecture within two weeks of the experience date (for the time being).
6.Those who are not in good physical condition on the day may be asked to refrain from attending.
7.Please be sure to check in at least 30 minutes before your visit.

■After submitting the form, we will send you a confirmation email or call you to confirm your reservation. If you do not hear from us, please call us and let us know that you have made a reservation.
■Please make a reservation at least 3 days in advance of your desired date of experience.

I agree with all of the above.