Healing Waves Registration Form

participant Registration form

Name *

First

Last

Email *

Contact Number *

Do you consent to being added to the private event WhatsApp group? *

Do you have swimming experience in the ocean? *

Emergency Contact Information *

List at least one emergency contact (name and phone number).

Select your preferred payment option. *

Comments or Questions

Liability Waivers *

I understand that surfing is considered an extreme sport and that there are certain inherent risks to my health. I have opted in to this session and accept all risks that may occur as a result of my participation in this program. I agree to follow all the safety guidelines that will be set out by my program facilitators. I understand that participants, including myself, may share private and personal information during the session, which may be triggering. I acknowledge that I am able at any point during the session to opt in/out of any activity as I feel. I agree to maintain the intimate space created during this session through respect of the trust of my fellow participants with complete confidentiality. I agree not to share the stories of other participants with anyone outside of the session group.