Hawaii Registration | Surfers Healing

Current Registration
Waiver
Complete

PLEASE NOTE:
Hawaii camps are not subject to the participant lottery, therefore participation is confirmed upon submission.
Camps are exclusive to particpants with special needs with no age restrictions.

Parent/Primary Contact Information

First Name

Last Name

Suffix

Street Address

City

Postal Code

State/Province

Country

Email

Mobile Phone Number

Participant Information

First Name

Last Name

Suffix

Gender

Birth Date

T-Shirt Size

Event

Participated in a Surfers Healing event before?

No

Yes

Registering Additional Campers with special needs?

If you wish to register additional campers (up to 3) please specify the required number and proceed. Please note that although we welcome the entire family to enjoy a day at the beach together, the surfing component of our camps is reserved exclusively for individuals with special needs.

Number of Additional Campers

Participant Information

First Name

Last Name

Suffix

Gender

Birth Date

T-Shirt Size

Event

Participated in a Surfers Healing event before?

No

Yes

Participant Information

First Name

Last Name

Suffix

Gender

Birth Date

T-Shirt Size

Event

Participated in a Surfers Healing event before?

No

Yes

Participant Information

First Name

Last Name

Suffix

Gender

Birth Date

T-Shirt Size

Event

Participated in a Surfers Healing event before?

No

Yes

Registration.

Please read carefully before proceeding

Parent/Primary Contact Information

Participant Information

Participant Information

Participant Information

Participant Information