Learn to Surf LA

SURF LESSONS REGISTRATION FORM

Step 1:
Please provide the following information:
Asterisk (*) fields are required. Please provide as much information as possible so we can better take care of you!

Personal Information:

* First Name
* Last Name
Gender	Male Female
*Primary Phone (Preferably Cell)
Secondary Phone (Home/Work/etc.)
*E-Mail Address
Street Address
Address 2 (Apt/Suite)
City
State
Zip Code
* Emergency Contact (Name)
*Emergency Contact (Phone)

Please let us know of any medical conditions you may have that would require
any special assistance. If none please leave blank:

Lesson Info:

* Type of lesson requested

NOTE: Adult Group lessons meet on Saturdays at 10am at the Santa Monica location. If registering more than one person for a group lesson, please indicate so in the comments field below.

*Location requested

* Date requested
Alt/2nd date requested
Alt/3rd date requested

NOTE: We will confirm date(s) and time(s) requested
if available or suggest alternatives if not.

Wetsuits:

Please enter the quantity for each size needed.
NOTE: If the wetsuit sizes listed do not match your height and weight, please select the most appropriate size for your weight and make a note of your
height and weight in the comments field below.

Check here if you will be bringing your own wetsuit

Quantity	Size	Height	Weight (lbs)
	4	4' 1" - 4' 3"	30 - 45
	6	4' 3" - 4' 5"	45 - 60
	8	4' 5" - 4' 7"	60 - 75
	10	4' 7" - 4' 10"	75 - 90
	12	4' 10" - 5' 1"	90 - 105
	14	5' 2" - 5' 5"	105 - 120
	XS	5' 5" - 5' 7"	120 - 140
	S	5' 7" - 5' 9"	135 - 155
	M	5' 9" - 5' 11"	150 - 170
	L	5' 11" - 6' 1"	170 - 185
	XL	6' 1" - 6' 2"	185 - 210
	XXL	6' 2" - 6' 3"	210 - 230
	XXXL	6' 3" +	230 - 250