Surf Camp Registration - Peaks n' Swells Surf Camp

Personal Information

Name*

First Last

Email*

Phone*

Number of people in your group

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Age

Weight

Height

Occupation

A Little More About You

Desired dates of your trip

Main goal of your trip?

Please describe

How did you hear about Peaks n' Swells Surf Camp?

Who can we thank?

Which social media channel?

Please describe

Have you surfed before?

Yes
No

How long have you been surfing and what type of board do you surf?

Are you bringing a surfboard?

Yes
No

How often do you swim?

Please rate your surfing ability from 1-4

Other sports/interests?

Any concerns, special interests or questions?

Interested in a family session? Please list the names, ages, height, weight, and surfing ability of everyone in your party.

Medical conditions?

Yes
No

Please explain

Allergies?

Yes
No

Please explain

Need medications during the trip?

Yes
No

Please explain

Favorite food for snacks?

Does anyone in your group have food allergies?

Yes
No

Please describe

Any further comments?

Emergency Contact #1 Name

First Last

Emergency Contact #1 Email

Emergency Contact #1 Phone

Emergency Contact #2 Name

First Last

Emergency Contact #2 Email

Emergency Contact #2 Phone

Medical Insurance Information. Ensure your medical insurance policy covers you while in Costa Rica. If not, overseas medical insurance is REQUIRED. A company that sells overseas insurance is Travel Guard International at 1-877-216-4885

Flight Information. Please provide San Jose and Tambor Flight Information for your travel to Peaks 'n Swells

I'd like to get your e-news

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Phone

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Personal Information

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