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SURF LESSONS REGISTRATION FORM
Step 1:
Please provide the following information:
Asterisk (
*
) fields are required. Please provide as much information as possible so we can better take care of you!
Personal Information:
*
First Name
*
Last Name
Gender
Male
Female
*
Primary Phone
(Cell number for a contact who will attend the lesson)
Secondary Phone
(Home/Work/etc.)
Street Address
Address 2
(Apt/Suite)
City
State
Zip Code
Emergency Contact Name
Emergency Contact
Phone
Please let us know of any medical conditions you may have that would require any special assistance? If none please leave blank:
Confirmation Info:
We will email a confirmation to each email address you provide below.
*
E-Mail Address
Alt/2nd E-Mail Address
Alt/3rd E-Mail Address
Lesson Info:
*
Number of Students
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Total $
*
Number of Lessons
1
2
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5
6
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10
Pricing & Discounts
*
Type of lesson
Select
Private Lesson
Adult Progressive Group Lesson
Stand Up Paddle Board Lesson
Supervised Surf Session
Private Parties/Corporate Group Lesson
Summer Schedule:
Private Lessons
available daily between 8am and 6pm
Adult Progressive Group Lessons
available July 1st through Labor Day at
8am on weekends
, and at
2:15pm daily at one of our Santa Monica locations
.
Supervised Surf Sessons
available at
8am on Saturdays
at one of our Santa Monica locations
.
Winter Schedule:
Private Lessons
available during daylight savings time daily between 8am and 6pm (outside of daylight savings time lessons are available between 8am and 4pm)
Adult Progressive Group Lessons
available Labor Day through June 30th at
10am on Saturdays at one of our Santa Monica locations
.
Supervised Surf Sessons
available at
8am on Saturdays
at one of our Santa Monica locations
.
*
Date requested
Month
Jan
Feb
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Dec
Day
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Time
8:00am
10:00am
12:15pm
2:15pm
4:15pm
Alt/2nd date requested
Month
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Time
8:00am
10:00am
12:15pm
2:15pm
4:15pm
Alt/3rd date requested
Month
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8:00am
10:00am
12:15pm
2:15pm
4:15pm
4th date requested
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Time
8:00am
10:00am
12:15pm
2:15pm
4:15pm
5th date requested
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8:00am
10:00am
12:15pm
2:15pm
4:15pm
6th date requested
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Time
8:00am
10:00am
12:15pm
2:15pm
4:15pm
7th date requested
Month
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Time
8:00am
10:00am
12:15pm
2:15pm
4:15pm
8th date requested
Month
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Time
8:00am
10:00am
12:15pm
2:15pm
4:15pm
9th date requested
Month
Jan
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Day
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Time
8:00am
10:00am
12:15pm
2:15pm
4:15pm
10th date requested
Month
Jan
Feb
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Day
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Time
8:00am
10:00am
12:15pm
2:15pm
4:15pm
NOTE
: We will confirm date(s) and time(s) requested
if available or suggest alternatives if not.
Location:
*
Location requested
Select
Santa Monica - Tower 18
Wetsuits:
Please enter the quantity for each size needed.
NOTE:
If the wetsuit sizes listed do not match your height and weight, please select the most appropriate size for your
weight
and make a note of your
height and weight in the comments field below.
Quantity
Size
Height
Weight
Own
Student will bring their own wetsuit(s)
4
4' 1" - 4' 2"
(124-127cm)
30 - 45 lbs
(14-20kg)
6
4' 2" - 4' 5"
(127-135cm)
45 - 60 lbs
(20-27kg)
8
4' 5" - 4' 7"
(135-140cm)
60 - 75 lbs
(27-34kg)
10
4' 7" - 4' 10"
(140-147cm)
75 - 90 lbs
(34-41kg)
12
4' 10" - 5' 1"
(147-155cm)
90 - 105 lbs
(41-48kg)
14
5' 1" - 5' 4"
(155-163cm)
105 - 115 lbs
(48-52kg)
XS
5' 4" - 5' 6"
(163-168cm)
115 - 130 lbs
(52-59kg)
S
5' 6" - 5' 8"
(168-173cm)
130 - 145 lbs
(59-66kg)
M
5' 8" - 5' 11"
(173-180cm)
145 - 165 lbs
(66-75kg)
L
5' 11" - 6' 1"
(180-185cm)
165 - 185 lbs
(75-84kg)
XL
6' 1" - 6' 2"
(185-188cm)
185 - 205 lbs
(84-93kg)
XXL
6' 2" - 6' 3"
(188-191cm)
205 - 225 lbs
(93-102kg)
XXXL
6' 3" +
(191cm +)
225 - 250 lbs
(102-114kg)
If Paying by Gift Certificate, Enter Number Here
Referral/Coupon Code
Any Additional Info/Comments?
Invite Your Friends!
If you would like to invite some friends to join your lesson,
enter their email addresses here:
Add a message for your friends here
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