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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
(Cell number for a contact who will attend the lesson)
Secondary Phone
(Home/Work/etc.)
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:



Confirmation Info:
We will email a confirmation to each email address you provide below.
* E-Mail Address
Alt/2nd E-Mail Address
Alt/3rd E-Mail Address
Lesson Info:
* Number of Students Total $
* Number of Lessons Pricing & Discounts
* Type of lesson
    Winter Schedule:
  • Private Lessons available during daylight savings time daily between 8am and 6pm (outside of daylight savings time lessons are available between 8am and 4pm)
  • Adult Progressive Group Lessons available Labor Day through June 30th at 10am on Saturdays at one of our Santa Monica locations.
* Date requested
Alt/2nd date requested
Alt/3rd date requested
4th date requested
5th date requested
6th date requested
7th date requested
8th date requested
9th date requested
10th date requested
NOTE: We will confirm date(s) and time(s) requested
if available or suggest alternatives if not.
Location:
*Location requested
WE WILL EMAIL YOU CORRECT LOCATION DIRECTIONS. Please check your confirmation email for correct location directions! Thanks!
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.
Quantity Size Height Weight
Own Student will bring their own wetsuit(s)
4 4' 1" - 4' 2"
(124-127cm)
30 - 45 lbs
(14-20kg)
6 4' 2" - 4' 5"
(127-135cm)
45 - 60 lbs
(20-27kg)
8 4' 5" - 4' 7"
(135-140cm)
60 - 75 lbs
(27-34kg)
10 4' 7" - 4' 10"
(140-147cm)
75 - 90 lbs
(34-41kg)
12 4' 10" - 5' 1"
(147-155cm)
90 - 105 lbs
(41-48kg)
14 5' 1" - 5' 4"
(155-163cm)
105 - 115 lbs
(48-52kg)
XS 5' 4" - 5' 6"
(163-168cm)
115 - 130 lbs
(52-59kg)
S 5' 6" - 5' 8"
(168-173cm)
130 - 145 lbs
(59-66kg)
M 5' 8" - 5' 11"
(173-180cm)
145 - 165 lbs
(66-75kg)
L 5' 11" - 6' 1"
(180-185cm)
165 - 185 lbs
(75-84kg)
XL 6' 1" - 6' 2"
(185-188cm)
185 - 205 lbs
(84-93kg)
XXL 6' 2" - 6' 3"
(188-191cm)
205 - 225 lbs
(93-102kg)
XXXL

6' 3" +
(191cm +)

225 - 250 lbs
(102-114kg)
If Paying by Gift Certificate, Enter Number Here
Coupon/Promo Code
Any Additional Info/Comments?
Invite Your Friends!
If you would like to invite some friends to join your lesson,
enter their emails here:
Add a message for your friends here
How did you hear about us?
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I agree to Learn to Surf LA's Terms and Conditions


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