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PISMO BEACH SURF ACADEMY

Surf Lesson Waiver

First Name(s) of Adult

Last Name(s) of Adult

Phone Number(s)

Email(s)

Address

Name of Minor(s)

Signature

I declare that the info I’ve provided is accurate & complete

I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I also acknowledge that I have viewed and read the attached "Surf Lesson Release of Liability and Assumption of Risk Agreement"View Agreement/Release

Thanks for submitting!

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