You may print this form
and mail to our office.
REGISTRATION FORM
FSA SURFER GIRL CAMP
NAME OF PARTICIPANT: ________________________________________________________
ADDRESS:
________________________________________________________
CITY:
________________________________________________________
STATE:
________________________________________________________
ZIP CODE:
________________________________________________________
EMAIL:
________________________________________________________
TELEPHONE:
________________________________________________________
PARENT OR GUARDIAN:
________________________________________________________
ADDRESS: (IF DIFFERENT) ________________________________________________________
________________________________________________________
________________________________________________________
EMERGENCY CONTACT:
________________________________________________________
EMERGENCY CONTACT TELE: ________________________________________________________
SPECIAL NEEDS
________________________________________________________
(ALLERGIES, MEDICINE)
________________________________________________________
SURFING ABILITY: CIRCLE BEGINNER
INTERMEDIATE
ADVANCED
FSA USE ONLY:
CONFIRM REGISTRATION: _______ SESSION # _______
DATE: ________
PRE-CAMP REMINDER NOTICE: _________
METHOD OF PAYMENT: _______________
BALANCE: ________________