NOTE: Cal Coast Adventures does not accept paper waivers, please submit electronically.

Medical Release and Emergency Contact

Keeping your kids safe is our top priority. Please complete this short health questionnaire and emergency contact form.

Name of Participant

Name of Legal Guardian

Address

Legal Guardian Contact Number

Additional Emergency Contact Name, Relationship, and Phone Number

Allergies

Please list all allergies for your kid(s)

Significant medical history or conditions we should know about:

Insurance Company

If none, put n/a

Policy Number

if none, put n/a

In case of emergency, persons who may be contacted and to whom the participant may be released to:

Name and phone number

Assumption of Risks: Participation in the Activity carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injury. The specific risks vary from one activity to another, but the risks range from (1) minor injuries such as scratches, bruises, and sprains, to (2) major injuries such as eye injury, joint, tendon, ligament or bone injuries, heart attacks, and concussions, to (3) catastrophic injuries such as paralysis, brain damage and death. To the best of my knowledge, the participant is currently in good physical condition and fully able to participate in all Santa Barbara Surf School activities.

I have read and agree to the above

I certify that I have adequate insurance to cover any injury or damage I, or my child, may suffer while participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I am willing to assume the risk of any medical or physical condition I may have and that I have made the Santa Barbara Surf School staff aware of these conditions.

i have read and agree to the above

Should a serious injury or accident occur and we are unable to contact the parents and/or family physician, permission is hereby granted for medical care to be given as required. The Undersigned Parent or Guardian is Responsible for Any Fee Involved.

I have read and agree to the above

By signing this, I grant to Santa Barbara Surf School the right to use and incorporate, in whole or in part, photographs or video footage taken of me, or my child, as a result of my participation at surf camp for use by Santa Barbara Surf School surf camp.

I have read and agree to the above

Reminders:

- Please send your child to camp with a snack and at least 16oz of water.

- Please apply sunscreen prior to drop off.

- All of our instructors are CPR and First Aid certified. We will have first aid on site for minor injuries and will contact you with any child need for medical attention.

- Please keep your phone on you during this time so that we can contact do you if needed

- We will have scheduled water and bathroom breaks but remind your children to tell us if they’re feeling thirsty or tired, we want to prevent any heat stroke from happening during this time.

Thanks and we look forward to getting everyone on some waves!

NOTE: Cal Coast Adventures does not accept paper waivers, please submit electronically.

Surf Camp Medical Release and Emergency Contact Form