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A Youth Surf Camp for Ages 6-15


Amount
(1 week = $250. for each additional week $200 / additional week.)
Participant's Name:*
(First Name) (Last Name)
Date of desired session:*
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Date of desired session 2 :
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Date of desired session 3 :
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Date of desired session 4 :
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Will you need a surfboard? :*
Level of ability:*
Age: *
Which school your child attends:*
Special Needs Allergies:*
Family Doctor Name :*
Family Doctor Phone :*
   
Parent/Legal Guardian's :*
(First Name) (Last Name)
   
Parent/Legal Guardian's Email:*
Address:*
  (Address 1)
 
  (Address 2)
 
  (City)
 
  (State)
 
  (Zip Code)
   
Phone:*
  Home Phone
 
  Work Phone
 
  Cell Phone
Emergency Contact:*
(Name) (Relationship) (Number)
How did you hear about us?:
I, the undersigned, being parent, legal guardian, or person in charge of the above named minor participant, in consideration of being permitted to participate in the surf camp program, do hereby give permission for said minor to participate and do release P.V. Surf, its officials, camp instructors, employees, of any and all liability or responsibility arising from any injury received or incurred by participation in this program or its activities. I further understand that water activities are dangerous and accidents can happen. I also understand that my child must be a good swimmer and is capable of participation in ocean water activities. I also give permission for the camp director to make any emergency decision needed for the safety of my child. It is also understood that jelly fish, stingrays, etc. are all part of the ocean's hazards, and will not hold any of P.V. Surf's personnel liable. Any pictures taken during the camps may be used in future publications for P.V. Surf.
 
 
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