Surf Camp Registration

Overnight Camp Dates: July 28 - August 1, 2008
Adventure Camp Dates: June 23 - August 29, Weekly

Please read the instructions below and fill out the information carefully.
 This registration form and the release form must be completed. The release form must be printed, completed and delivered to Soul Surfing School. Fields with red * are required.
Contact Information
Camper Name *
Address *
City *
State *
Zip *
Phone * (format=949-123-4567)
E-mail * (format=user@domain.com)
Re-Enter E-mail * (format=user@domain.com)
Birth Date Month: * Day: * Year (YYYY) *
Soul Surfing Camp Times and Dates
If you are registering for the Soul Adventure Camp , select a week and a backup below.
For the Overnight Camp, select "Overnight Camp" in the drop down menu IN BOTH FIELDS.
Date
Backup Date
Camper Information
Please provide the following information:
Overnight Camper Info
T-Shirt Size *
Height *
Weight *
Special Needs Information
Do you have a Medical Condition or Dietary Need that we should know about?*
YES
NO

Please provide Medical or Dietary details:
Do you need pick-up from the airport or train station?*  
YES
NO

If "YES" please provide Travel Itinerary:
Emergency Contact
Name *
Relationship *
Phone * (format=949-123-4567)
One more Question
How did you hear about the Soul Surfing Overnight or Adventure Camps?

Agreement  
* This form and the release form signed and returned.
* I certify that I or my child is qualified to swim in the ocean and understand that any violation of rules set forth by "Rules of the Beach" on my part or on the part of my child will be due cause for me or my child's immediate dismissal from this school with NO REFUND. I also understand that any deposit and/or tuition is "NOT REFUNDABLE". I acknowledge that I have read and understand all of the above.
* In addition, all pictures taken at camp can be used to promote camp through advertising. In the event of a beach closure, all water activities will be restricted until the State Park authorities provide the camp management with the all clear to re-enter the water.
Payment Information
  Payment Information: Please send check or money order to:
Soul Surfing School
255 Oak St, Laguna Beach, Ca. 92651
or for credit cards use PAYPAL on our Soul Store Page.
   
 

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