Each participant must have a separate, signed, registration form prior to the first class. For multiple registra-
tions, fill out one form with similar information, make a copy, and then fill out unique information for each student.
Participant Name: _________________________ Parent/Guardian Name: ____________________________
(Required for anyone under 18 years of age.)
Phone Number: ___________________________ Parent/Guardian Cell #: ____________________________
Address: _________________________________ Participant Birth Date: ____________________________
City: ____________________________________
State: _______________ Zip: ______________ Email Address: __________________________________
Projected Start Date: ________________________ Type of Surfing Class? (check below)
Comments: (please let us know how you found M&M) ___ 3 Hour Group Lesson … $65.00 for 3 hours
___________________________________________ ___ Semi-Private Hourly ..… $80.00 per hour
___________________________________________ ___ Surf Camp Weekly …… $250.00 for 5 days
___________________________________________ ___ Surf / Oceanography .... $325.00 for 5 days
___________________________________________ ___ Special Occasion ......... Call/email for pricing
Emergency Contact: _________________________ Emergency Phone: ____________________________
Describe all allergies, current medications, and/or pre-existing medical conditions: ________________________
_____________________________________________________________________________________________
By signing this waiver, I intend to be legally bound and acknowledge that the possibility of my child/myself being injured while attending the
come with the sport of surfing and ocean do exist. This waiver is a release limiting your right to recover any damages in case of accident. This
waiver must be signed by the participant to be admitted to
and in addition, my heirs/executors/estate administrators to be bound, to hold harmless and release M & M Surfing School, U.S. Government,
the State of California, the County of Orange, the County of Los Angeles and cities of Huntington Beach, Sunset Beach and Seal Beach, their
employees/agents from any responsibility or liability, arising from injury and/or property damage. I further understand and acknowledge that
any violation of the rules of conduct set forth by the “Rules of the Beach” on my part or the part of my child will be due cause for the immediate
dismissal from M & M Surfing School, with no refund. Proof of participant’s age may be required.
By signing below, I acknowledge that I have read and understand this release form.
Participant or Parent/Guardian: __________________________________ Date: ________________________