Survivor Summit Surf Camp Application September 19

Participant

First Name

Last Name

Phone Number

Email Address

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Age

Shirt Size

Height

Height and weight will be used to select correct gear sizing for the participant.

Weight

Height and weight will be used to select correct gear sizing for the participant.

Guests Full Name

How has cancer affected your life?

How did you learn about the Survivor Summit Surf Camp?

We will have a beach gourmet box lunch from Graze Charcuterie. Please indicate below: No restrictions or vegetarian.

Do you have any special physical or mental needs we need to be aware of, or anything important that will help us prepare to give you the best surf lesson possible?

Learning to surf is a physical activity involving elevated heart rate while listening to instruction from our staff. It is very similar to learning how to swim or ride a bike. Are you physically healthy enough to learn how to surf?

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Survivor Summit Surf Camp Application September 19

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