Surf Camp Registration

sURF CAMP REGISTRATION

Full Name*

Email Address & Phone Number*

Age*

Height, Weight & Size (S, M, L, XL)*

Social Skills (From 1 - 10)*

Allergies, Injuries, Medical Conditions*

Swimming Skills (From 1 - 10)? Surfing Experience? Ocean Experience?*

Other Regularly Practiced Sports? Previous Camp Experience?*

Parents Full Name & Phone Numbers*

Emergency Contact (Full Name & Phone Number)*

Does Your Child (Or Children) Have Their Own Wetsuit / Surfboard?*

Who Will Be Picking Up / Dropping Off Registrant? (If More Than One Person - Please List Full Names & Phone Numbers That Apply)*

Full Billing Address & Zip Code

Card Type (VISA, Master Card, AMEX, Discover)

Full Name On Card

Card #

Expiration Date

C V V (Code In The Back, Usually 3-4 Digits)

Please Specify Dates You'd Like To Book, Half Day Or Full Day?*

Notes

Do You Certify That All Of The Above Information Is True & Correct?*

TO HOLD YOUR SPOT, WE NEED TO HAVE A CARD ON FILE.

HOWEVER, WE DO ACCEPT OTHER PAYMENT METHODS SUCH AS VENMO, Apple Pay, CASH OR CHECK.

TO PAY BY VENMO:

@HeavenOnEarthSS

TO PAY BY Apple Pay:

310-993-2298