Gift Certificate Purchase Form

Want to give the gift of sea kayaking? Please use this form to enter your information. You will be directed to a payment page upon submission of this form.

    Date of Purchase

    Amount of Gift Card

    Purchaser Name and Contact Information:

    First Name

    Last Name

    Physical Address

    City

    State/Province

    Zip/Postal Code

    Country

    Email Address

    Confirm Email Address
    [checkmail confirm-email "email"]

    Phone Number

    Name and Contact Information of Person Receiving the Gift Card:

    First Name

    Last Name

    Physical Address

    City

    State/Province

    Zip/Postal Code

    Country

    Phone Number

    Gift Certificate Delivery Information:

    Would like for us to mail a paper copy of the gift certificate to either you or the recipient? If yes, please type the mailing address below.
    yesno

    Certificate Mailing Address

    Would like for us to email an electronic copy of the gift certificate to YOU? If yes, please type the email address below.
    yesno

    Purchaser Electronic Copy Email Address

    Would like for us to email an electronic copy of the gift certificate to the RECIPIENT? If yes, please type the email address below.
    yesno

    Recipient Electronic Copy Email Address

    Do you want to include a personal message on your gift certificate? Is so, please, include it below.
    yesno

    Personal Message

    How did you learn about us?

    Do you wish to receive emails from us that contain information about our programs? We will not distribute your email address to any other business or individual without your consent.
    yes, pleaseno, thanks

    Please enter the security code
    captcha

    *After you submit your information, you will be redirected to a page that will allow you to enter the gift certificate amount and make a secured payment.

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