• Surf Camps • Surfing Lessons • Private Instruction SURF CAMP REGISTRATION FORM *** PLEASE COMPLETE ALL FIELDS ***

760.809.3069 • Fax: 760.230.1378 • www.EliHoward.com P.O. Box 232690 • Encinitas, CA 92023

(we do notsell or give away any studentor client informationunderany circumstances)

Student’s Name

Parent or Guardian’s Name (if student is under 18)

Address

City

Day Phone

Evening Phone

Email Address

May we send you promotional email from ELI HOWARD SURF SCHOOL? (You will receive NO SPAM) YES

Student’s Age

State

Student’s Height

Zip

Student’s Weight

NO

Emergency Contact Name:

Emergency Contact Phone/s:

How did you hear about us?

Date(s) and Time(s) you wish to sign up for: INTERNET RETURNING SURFER! Overnight Surf Camp: __________________________________________________________________ MAGAZINE INTERNET BROCHURE MAGAZINE WORD OF MOUTH BROCHURE OTHER WORD OF________________________ MOUTH

Day Surf Camp (morning): ______________________________________________________________ Day Surf Camp (Afternoon): _____________________________________________________________ Weekend ____________________________________________________________________ Weekend Getaway: Escape: _____________________________________________________________________

OTHER ________________________ Other Lesson or Class: __________________________________________________________________ Deposit Amount Enclosed (non-refundable): $50/person Day Surf Camps Getaway $75/person deposit for Weekend Escape $200/person deposit for Overnight Surf Camp Balance is due at the start of the camp or lesson.

Ccomments, Special Needs, Medical conditions we should know about:

PLEASE BE SURE TO INCLUDE THE ‘ RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT’

WITH THIS FORM

ELI HOWARD SURF SCHOOL RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT ELI HOWARD SURF SCHOOL (bring this form to the beach)

RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT

This is a release. Read it carefully before signing. This release essentially states that I know I am taking a surfing lesson and will be entering the water at the (bring this form to the beach) beach. As a result of the inherent risks in this activity, I know I may die, get hurt, or damage my belongings. If any of these occur, I understand that I cannot make sue,Read or expect ELI HOWARD SURFThis SCHOOL, owners, officers, agents, the State of California, it’sthe Department of This isa aclaim, release. it carefully before signing. releaseits essentially states that I knowemployees, I am takingassociates, a surfing lesson and will be entering water at the Parks Recreation (hereinafter referred collectively ELI HOWARD SURF SCHOOL) to be legally responsible or pay Ifor any damages. beach.and As a result of the inherent risks in thistoactivity, I knowasI may die, get hurt, or damage my belongings. If any of these occur, understand that I cannot make a claim, sue, or expect ELI HOWARD SURF SCHOOL, its I,owners, officers, agents, employees, associates, thevoluntarily State of California, Department oflesson Parks and ACKNOWLEDGMENT AND ACCEPTANCE OF RISKS: the undersigned, hereby acknowledge that I have chosen toit’s take this surfing with Recreation, theSURF City ofSCHOOL. Encinitas (hereinafter referred to collectively as ELI HOWARD SURF SCHOOL) to be legallyaltered, responsible or pay for and any these damages. ELI HOWARD Certain risks are inherent in any recreational activity and cannot be eliminated, or controlled, risks that contribute to the uniqueAND character of the activity also be theundersigned, cause of injury, illness, death, andthat damages. know andchosen fully understand that surfing is an ACKNOWLEDGMENT ACCEPTANCE OF can RISKS: I, the hereby acknowledge I have Ivoluntarily to take this surfing lesson outdoor in anSURF uncontrolled natural environment with inherent and hazards where can occur, participants canand die,these sustain injuries with ELIactivity HOWARD SCHOOL. Certain risks are inherent in anyrisks recreational activity andserious cannot accidents be eliminated, altered, or controlled, risks that contribute to damage. the unique character of the activity can also be the cause of injury, illness, death, and damages. I know and fully understand that surfing is an and property activity in anwillingly uncontrolled natural with inherent risks and where serious accidents canrendezvous occur, participants die, sustain injuries Ioutdoor acknowledge and assume allenvironment risks and hazards in surfing andhazards beach-related activities from the until thecan conclusion of the class and property damage.but not limited to, (1) loss of control of the surfboard, falls from the surfboard, collision with other participants, equipment, other surfor lesson, including, I acknowledge and willingly assume allorrisks and hazards whether in surfing and beach-related activities from the rendezvous until the of the class or boards, rocks, and any other man-made natural obstacles, obvious or not; (2) judgment, decision-making and conduct of conclusion the instructors, excepting lesson, including, but not limited to, (1) of controlinof the surfboard, from the surfboard, collision with other participants, surfboards, acts of wanton or gross negligence; (3) loss submersion water, drowning;falls (4) encounters with animals, marine life and insects; (5)equipment, exposure other to outdoor ocean rocks, and any other man-made or natural obstacles, whether obvious or not; (2) judgment, decision-making conduct of activity; the instructors, excepting acts environment, extreme temperatures, sun, and inclement weather, including, travel by foot or vehicle in any wayand related to this (6) assistance in lifting of wanton or gross negligence; (3)(7)submersion in water, drowning; encountersofwith animals, marine life andmedical insects;attention (5) exposure ocean and/or carrying surfing equipment; rescue-related injuries; and (8) (4) unavailability immediate and appropriate in casetoofoutdoor injury. I underenvironment, extreme temperatures, sun, and inclement weather, including, travel by foot or vehicle in any way related to this activity; (6) assistance in lifting stand and acknowledge that the above list is not complete or exhaustive, and that other risks, known or unknown, anticipated or unanticipated, may also exist and/or carrying surfing equipment; (7) rescue-related injuries; and (8) unavailability of immediate and appropriate medical attention in case of injury. I understand and result in injury, illness, disease, death or damage. My participation in this activity is purely voluntary and I elect to do so at my own risk. and acknowledge that the above list is not complete or exhaustive, and that other risks, known or unknown, anticipated or unanticipated, may also exist and RELEASE: In consideration for death ELI HOWARD SURF SCHOOL allowing me to participate in this class orand lesson, I voluntarily release, result in injury, illness, disease, or damage. My participation in this activity is purely voluntary I elect to do so agree at my to own risk. discharge, and hold harmless ELI HOWARD for any and all claims of liability arising out of their negligence, fault, recklessness, or any other act or omission which causesand the RELEASE: In consideration for ELI HOWARD SURF SCHOOL allowing me to participate in this class or lesson, I voluntarily agree to release, discharge, undersigned illness, injury, disease, damages of any nature way connectedfault, with recklessness, my participation this surfing I alsowhich expressly agree hold harmless ELI HOWARD for anydeath, and alland claims of liability arising outinofany their negligence, or in any other act activity. or omission causes the to release and discharge HOWARD SCHOOL any actinorany omission, excluding wanton or in gross negligence, in Irendering or failing to undersigned illness, injury,ELI disease, death,SURF and damages offrom any nature way connected withacts my of participation this surfing activity. also expressly agree render anyand typedischarge of rescue, emergency medical services. signing document, I fully recognize understand that I (or anyor minor to release ELI HOWARDor SURF SCHOOL fromInany act or this omission, excluding acts of wanton and or gross negligence, inifrendering failingon to whose render behalf I am signing this release) am hurt, die, orInmy property is damaged, I amrecognize giving upand myunderstand right to make or file a lawsuit against ELII any type of rescue, emergency or medical services. signing this document, I fully thata ifclaim I (or any minor on whose behalf HOWARD SCHOOL, if they negligently by some other act orup omission, acts of or gross negligence, cause the am signingSURF this release) am even hurt, die, or my property or is damaged, I am giving my right excluding to make a claim or wanton file a lawsuit against ELIHOWARD SURF injury or damage. SCHOOL, even if they negligently or by some other act or omission, excluding acts of wanton or gross negligence, cause the injury or damage. further agree, agree, to to hold hold harmless, harmless, defend, from allall defense costs, including attorney’s fees incurred in connection IIfurther defend, and and indemnify indemnifyELI ELIHOWARD HOWARDSURF SURFSCHOOL SCHOOL from defense costs, including attorney’s fees incurred in connecwithwith claims for bodily injury, wrongful death, or property damage which I sustain, or which is, sustained by any underunder 18 years of age whose behalf I tion claims for bodily injury, wrongful death, or property damage which I sustain, or which is, sustained byminor any minor 18 years ofon age on whose am signing, or whichorI, which or the I,minor whose signing, havemay caused spectators or other third parties, whether not, in the behalf I am signing, or theonminor onbehalf whoseI am behalf I am may signing, havetocaused to spectators or other third parties,negligent whetheror negligent or course not, ofthe mycourse participation this activity.in this activity. in of myin participation As parent parent or or legal legal guardian guardian of of aa participant participant under under 18 18 years years of of age, age, II have have read read and and voluntarily voluntarily agree agree that that said said minor minor may may participate participate in As in this this surfing surfing lesson lesson or or class, and and IIsign signthis thisrelease releaseon ontheir theirbehalf behalfand andon onthe thebehalf behalfof ofthe theminor’s minor’sparents parentsand/or and/orlegal legalguardians. guardians. In In addition, addition, II give give ELI ELI HOWARD HOWARD SURF SURF SCHOOL SCHOOL class, permission to to treat treat said said minor minorin incase caseofofillness, illness,injury, injury,emergency, emergency,or oraccident. accident.Should Shouldemergency emergency medical medical services services become become necessary, necessary, for the undersigned undersigned permission for the participant or minor, the expenses are the sole responsibility of the participant and not that of ELI HOWARD SURF SCHOOL. Personal medical insurance participant or minor, the expenses are the sole responsibility of the participant and not that of ELI HOWARD SURF SCHOOL. Personal medical insurance is strongly advised for all participants. is strongly advised for all participants. ELI HOWARD SURF SCHOOL reserves the right to accept or deny service to any person. I hereby agree to follow all rules, regulations, and instructions of ELI ELI HOWARD SURF SCHOOL reserves the right to accept or deny service to any person. I hereby agree to follow all rules, regulations, and instructions of ELI HOWARD SURF SCHOOL while participating in this class or lesson. I also certify that I and any minor on whose behalf I am signing, are physically and mentally HOWARD SURF SCHOOL while participating in this class or lesson. I also certify that I and any minor on whose behalf I am signing, are physically and capable of participating in these activities. I hereby represent that I have informed ELI HOWARD SURF SCHOOL of any pertinent medical conditions that may mentally of participating in these activities. I hereby represent I have ELI HOWARD SURF SCHOOL any medical conditions affect mycapable or the minor’s participation in these surfing activities. I herebythat agree thatinformed ELI HOWARD SURF SCHOOL may use of film or pertinent photographic records of this that may affect my or the minor’s participation in these surfing activities. I hereby agree that ELI HOWARD SURF SCHOOL may use film or photographic surfing class or lesson for its promotional and/or commercial purposes without compensation to me. records of this surfing class or lesson for its promotional and/or commercial purposes without compensation to me. The venue of any dispute that may arise out of this agreement or otherwise between the parties to which ELI HOWARD SURF SCHOOL or its agents is a party The of Diego any dispute that may arise out of this agreement or otherwise between the parties to which ELI HOWARD SURF SCHOOL or its agents is a party shallvenue be San County. shall be San Diego County. I HAVE READ THIS DOCUMENT IN ITS ENTIRETY. I UNDERSTAND THAT I AM ASSUMING ALL THE RISKS INHERENT IN THIS SURFING ACTIVITY. IIHAVE READ THIS DOCUMENT IN ITS ENTIRETY. I UNDERSTAND THAT I AM ASSUMING ALL THE INHERENT IN THIS SURFING ACTIVUNDERSTAND THAT IT IS A RELEASE OF ANY AND ALL CLAIMS. I UNDERSTAND THAT THIS ISRISKS THE ENTIRE AGREEMENT BETWEEN THE ITY. I UNDERSTAND IT IS A RELEASE OF ANYTHEIR AND ALL CLAIMS. I UNDERSTAND IS THE ENTIRE AGREEMENT BETWEEN THE UNDERSIGNED ANDTHAT ELI HOWARD SURF SCHOOL, OWNERS, OFFICERS, AGENTS,THAT AND THIS EMPLOYEES, AND THAT IT CANNOT BE MODIFIED OR CHANGED IN ANY BY THE REPRESENTATIONS OR STATEMENTS BY AGENTS, ELI HOWARD SURF SCHOOL ORTHAT BY THE UNDERSIGNED. UNDERSIGNED AND ELIWAY HOWARD SURF SCHOOL, THEIR OWNERS, OFFICERS, AND EMPLOYEES, AND IT CANNOT BE MODI-I VOLUNTARILY SIGNIN MY NAME OF MY ACCEPTANCE OF ALL THEBY PROVISIONS IN THIS MYTHE AGREEMENT TO BEI FIED OR CHANGED ANY WAYAS BYEVIDENCE THE REPRESENTATIONS OR STATEMENTS ELI HOWARD SURFRELEASE SCHOOL AND OR BY UNDERSIGNED. BOUND BY THEM. VOLUNTARILY SIGN MY NAME AS EVIDENCE OF MY ACCEPTANCE OF ALL THE PROVISIONS IN THIS RELEASE AND MY AGREEMENT TO BE BOUND BY THEM. Name of participant

Day Phone

Address

City, State, Zip

Evening Phone

Email Address

 Check here if you DO NOT wish to receive an occasional email from us Are you over 18 years of age?    Yes  No - Accompanying adult must sign and date here:   

Signature (If participant is under 18 parent or legal guardian must sign here)*

Class Date

Today’s Date

*Minors not accompanied by their parent must bring this form signed by their parent or legal guardian. Adult accompanying the minor must also sign this release as a verification of the parent/ guardian signature. Please bring this form to the beach.

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SCOUT PROGRAMS

AWESOME LESSONS AND BEACH CAMPOUTS

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SCOUT OVERNIGHT

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A SURF LESSON OUTSIDE OF OUR PRIVATE COASTAL SURF CAMP- CHALLENGE, SHARE, AND ENJOY!

Participant Name: Girl Scout of San Diego County Troop # Contact Name: Contact Address:

“Wow, what an incredible experience you provided for the girls! I know this is something they will always remember! We appreciate your great interaction with them, your awareness of their safety, and overall fun beyond imagination. We will be back!”

MeetingTime: Saturday

Reservation Confirmation

Noon- Noon

Your reservation is confirmed! Thank you for your deposit of $XXXXX transferable up to a year. The balance and both registration forms (for each participant) are due the at the time of check-in for your adventure. Please email a list of final numbers and heights/weight for your gear to be ready for you upon arrival. For questions please check out our new Scout page on our website in our surf camp section or call us directly. We look forward to teaching you how to surf!

Check Out Surfing! Looking for an adventure for you and friends? Learn to surf in lessons and campouts as you gain important skills in the ocean. Lessons help you develop the fundamentals of surfing using balance & posture. Scouts also learn skills to care for your equipment, how to paddle, and acquire confidence in the ocean. Scouts may gain focused surfing topics and choose to explore their local beaches through a community clean-up. Drop in with a 2 hour lesson, body surfing, and hang out in beachside camping! Our cool instructors also provide tasty BBQs, Dutch Oven Treats, and warm breakfasts. Scout Overnights are in our beautiful & private State Park campsite, complete with a surf lounge, ping-pong, surfing library, and tons of optional activities such as: checking out the tide pools, campfire fun of storytelling and stargazing and building leadership skills in camp cookery! Join your friends and our patient instructors to learn to surf and explore!

ELI HOWARD

2 HOUR LESSON

Time:

Offered Daily, Year-round

Fridays, Saturdays, Sundays March- October Noon-Noon

Fee:

$45 per Scout

$92 per surfer $45 non-surfer

Scout Programs

All ages and abilities welcome!

OVERNIGHT

Place:

San Elijo State Beach & Moonlight Beach, Encinitas

Contact: Emily at 760.809.3069 [email protected] EliHoward.com Other:

Surfboards and wetsuits provided; 3:1 student to instructor ratio; Campsite includes: Tents, sleeping pads, covered kitchen Lesson Minimum: 8 Overnight Maximum: 14 Advanced Reservations Required Scouts may earn Junior Surfing Badge, Surfing IP, & others!

Scout Overnight San Elijo State Beach

Eli Howard’s Scout Overnights are a structured surfing adventure designed to provide quality surfing instruction, exploratory activities, and a night of memorable beach camping.

During their overnight, Scouts will receive up to two hours of awesome surfing instruction as well as time to explore the ocean. Students will spend their camp days learning important water safety skills, surfing fundamentals, and exploring the State Parks* coastal environments. Students will also have the opportunity to relax and enjoy other outdoor activities such as body boarding, body surfing, and other beach games. Students are also provided with instruction in caring for surf gear, ocean conservation tips and their choice of themes and activities in the afternoon. Daily activities may include beach clean-ups, camp cookery seminars, California coast exploration, and evolution of surfing culture. Surf camp evenings will begin with a hearty meal prepared by Eli Howard’s camp chef and instructors. Camp menus may include grilled burgers and homemade fries, tropical fruit, hot pancakes and yummy Dutch oven desserts. All meals will have a variety of food choices as well as offer a vegetarian option. Special needs can always be arranged in advance.

As the sun sets over the Pacific students may relax with board games, enjoy our surfing library, play ping-pong, as well as lounge around a cozy campfire and enjoy s’mores & hot cocoa. All of our camps include the use of a full Billabong wetsuit and BZ surfboards as well as tents and sleeping pads! Surfers are welcome to bring their own gear if they would like and if possible it is always nice to get help to the next level with their own gear! Eli Howard instructors support a non-competitive environment and put safety as their first priority. All staff members are First Aid and C.P.R. certified and head instructors are all American Red Cross lifeguards. It is suggested that one scout leader be present per every seven scouts. Leaders are always welcome to participate in all surfing activitiesit's a blast!

Directions to San Elijo ✦

Exit the 5 Freeway at Birmingham Drive and go west.

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Turn left on San Elijo Avenue.

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Turn right on Chesterfield Drive and continue over the railroad tracks.

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Turn right onto the Coast Highway.

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Free parking is available on the Coast Hwy- Please follow posted signs.

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The State Park entrance will be on your left.

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A Day-Use Fee area will be 200 feet further on the left, where a u-turn can bring you back to the entrance, for dropping off a student or surfer.

DROP OFF AREAS: ✦

If dropping off a student or camper, make a u-turn at the Day Use parking lot and proceed back to main entrance.

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Eli Howard’s Campsite is located at the main entrance of the State Park

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Let the park attendant know that Eli Howard is expecting you.

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Please use the 20 minute parking available just inside the main entrance next to the kiosk.

ELI HOWARD SURF CAMP!