How Would You Like To Pay:

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Personal Information

Camper's First Name: Camper's Last Name:

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Street Address: City:

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State: ZIP:

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Home Phone: Work Phone:

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Camper's E-Mail:

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Age: Gender: Choose One --------- Male Female

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Roomate Preference: Level of surfing ability: Choose One ----------- First Time Beginner Intermediate Advanced

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Weight: Height: T-Shirt Size: Choose One --------- XS S M L XL

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Do you need airport pick-up and/or drop-off?     Yes No

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Which camp date will you be attending? Choose One ------------------------- July 14th - 18th, 2008 : Ages 11-14 July 21st - 25th, 2008 : Ages 15-18

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Comments regaurding the campers diet, medications, allergies, etc.:

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How did you hear about us?

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Billing Information

First Name: Last Name:

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Street Address:

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City: State: ZIP:

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E-Mail (your receipt will be sent here):

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Credit Card Type: Choose One --------- Visa Master Card American Express

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Credit Card Number: Exp. Date:

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