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Indo Jax
®
Surf School
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Register Today!
2023 Charity Surf Camp Registration Form
Registration Information
Participant Name
Parent/Guardian Name
Height
Weight
Age
Street Address
City
State
Zipcode
Email Address
Phone Number
Special Instructions
- Please add any additional information that might be beneficial for us to know such as mobility issues, etc.
.
Select Camp and Dates
West Coast Special Needs Camp Waiting List- Pismo Beach
9:00AM-12:00PM
July 25-27
East Coast Childhood Cancer Camp - Wrightsville Beach
5:00PM-7:00PM
August 15-16
East Coast Visually Impaired Camp - Wrightsville Beach
5:00PM-7:00PM
August 23-24
Wavers and Consent
By checking this box you indicate that you have read and agree to the Waiver
(
Click Here to Read the Waver
)*
By checking here, I indicate I do NOT consent to the use of photographs or likeness of me taken by Indo Jax® Surf School for their own purposes.
*required