Week Retreat Registration Form

Surf Camp Week Retreat Registration Form

Register and pay online with active.com – Use your Visa, Mastercard or Debit Card to pay. Processing fees apply. Active.com will email your camp confirmation.

To send by mail: Click on the link below which will open up a printable form. Simply print out the form, fill it out, and send with payment (check or money order) to NW Women’s Surf Camps, PO Box 425, Seaside, OR  97138.

Printable Week Retreat Registration Form

To send by email: Simply fill out the form below and press “send”! Then mail your payment (check or money order) to above address.  We must receive your payment in order to confirm your camp registration.  Thank You!

Liability Waiver Form

Participant's Name

Participant's Date of Birth: Age:

Participant's Email:

Participant's Street Address:

City: State: Zip:

Local phone: Cell phone:

Home phone: Work Phone:

Swimming Level:

Ocean Skill Experiencel:

Emergency Contact Name:

Emergency Contact Phone:

Physician's Name:

Physician's Phone:

Do you have medical insurance? yesno

Medical Insurance Company: Policy #:

Dates of Retreat you're attending

Person you may be attending the Retreat with:

If possible, name the person you'd like to share a room with: