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Parent / Guardian name *

First

Last

Emergency Contact on the day(s) of attendance *

First

Last

Phone Number *

Child Name 1 *

First

Last

Date of birth *

Child Name 2

First

Last

Date of birth

Child Name 3

First

Last

Date of birth

Child Name 4

First

Last

Date of birth

Any other needs/ Allergies / Medical Conditions

Paddleboarding Experience if any

I allow my child to be in photos that may be used for marketing purposes. *

Yes
No

Terms and Conditions

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