Checkboxes *I agree to the Release Statement as detailed below.RELEASE & HOLD HARMLESS AUTHORIZATION FOR A MINOR PARTICIPANT
For and in consideration of the participation in all Free Spirit Surf LA, and with understanding that said participants will engage in various physical activities on the beach and waters of the Pacific Ocean, we (the undersigned parents or guardians) of the child participant, a minor do forever release, acquit, discharge, and hold harmless Free Spirit Surf LA, County of Los Angeles and its successors, offers, employees, volunteers, servants and agents from any and all actions, claims, damages, cost, loss of services, expenses, and compensation, on account of or in any way growing out of any and all known or unknown personal injuries and property damage which we may not or hereafter have as parents and/or guardians of said minor, and also all claims or rights of action for damages which the said minor has or may hereafter have either before or after he reached his majority, resulting or to result from in connection with participation in and/or arise out of travel to or returning from said program. We the undersigned hereby acknowledge to be lawful parents and/or guardians of the above mentioned minor and we therefore acknowledge our qualifications to sign the agreement on behalf of the said minor. Furthermore in accordance with chapter 1524, Section 25.8 of the Civil Code of California, I give authorization to any physician or surgeon, licensed under the provision of Medical Practice Act, for the said participant to receive medical care and/or emergency treatment when necessary. Any expenditure for care is my personal responsibility.Participant Name *FirstLastParticipant Age *Surfing Skill Level *BeginnerIntermediateExpertMale or Female body typeMaleFemaleThis information is necessary in order to determine the type of wetsuit and surfboard needed for best results during the lesson.Height/Weight *3.0-3.5′ / 50-100lbs4.0-4.5′ / 100-150lbs5.0-5.5′ / 150-200lbs6.0-6.5′ / 200-250lbs7.0-7.5′ / 250-300lbsDoes the Participant have special needs? *YesNoIf the Participant has special needs, please describe…Emergency Contact Name and Phone Number *Select Type of Lesson or Party (and length) *Surfing Lesson – 90 minutesSurfing Lesson – 2 hoursSurfing Lesson – 3 hoursSurfing Lesson – 4 hoursPrivate/Group Surf/Stand Up Paddle LessonAdvance Private/Group Surf/Stand Up Paddle LessonWeekend Group ClassesCorporate Surf/Stand Up Paddle LessonBeach Surfing Party (4 hours max)Birthday Surfing Party (4 hours max)Kip Jerger’s Master Surfing ClassWounded Warriors Lessons (2 hours)Special Needs Surfing LessonsLessons for Wounded Warriors, the visually impaired, and the physically challenged are 2 hours long.
Please contact us at 310-308-7264 prior to the lesson to prepare for special accommodations.For Group Lesson or Party Requests, what is the estimated number of guests?In most cases, rates are estimated on the number of those attending. Number of attendees can change before the lesson. This is just an estimation.Lesson Location *MalibuVenice BeachManhattan BeachHuntington BeachADULT GUARDIAN INFORMATION – Relationship to the Participant *SelfMotherFatherGuardianOtherIf Other, please describe…Guardian Name (if none, just enter self) *FirstLastAddress – street *Address – city, state, zip *Phone Number *Email *Preferred Method of Payment *CashCheckMoney OrderPaypalVenmoCredit CardMessageSubmit