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PISMO BEACH SURF ACADEMY
Surf Lesson Waiver
First Name(s) of Adult
Last Name(s) of Adult
Phone Number(s)
Email(s)
Address
Name of Minor(s)
Signature
I declare that the info I’ve provided is accurate & complete
I hereby acknowledge this release from liability for accidental injury or illness which I may incur as a result of participating in any physical activity. I hereby assume all risks connected therewith and consent to participate in this program. I also acknowledge that I have viewed and read the attached "Surf Lesson Release of Liability and Assumption of Risk Agreement"
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