Little Surf Co. Institute 2026/2027 School Year Registration and Payment Form

For program options and details, please review our website first before completing this registration. (https://www.littlesurfcoinstitute.com/programs)

IMPORTANT UPDATE: Some Classes / Programs have filled on certain days and are currently on a waitlist

(please email littlesurfco@gmail.com if you would like to be added to the waitlist for one of those classes/programs, otherwise, you may register for other programs/days)
Little Surf Co. Institute 2026/2027 School Year Registration and Payment Form

Please fill out One Registration and Payment Form Per Student
Student Name

First NameLast Name
Grade Level Child is entering
Student Birth Date

MonthDayYear
Date
Parent/Guardian Name (*additional Parent/Guardian can be added after onboarding)

First NameLast Name
Parent/Guardian Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian Email
example@example.com
Home Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Student Questionaire
Student Surf Skill Level (if surfing, if not put N/A)
Allergies/Additional Special Needs Required
Do you have reliable transportation?
Marital Status
Members living in the household. Please list all names, ages, and whether any of them are convicted. If convicted, please explain.
Special Interests of the child.
Please list any and all behavioral tendencies or learning disabilites we should be aware of. Please be detailed.
Previous School/Program History. Please list the last 3 schools/programs your child attended and reasons for leaving?
What attracted you to the Little Surf Co. Institute?
Why do you think your child is a good fit for our program?
Questions/Comments/ Additional information we should be aware of?
Program Registration Selection

Pick your programs and add on's
LSC Learning Center (11:15AM-2:45PM)
Choose one
LSC Learning Center - Attendance (Choose days of attendance)
LSC Little Ocean Explorers Preparatory (11:15AM-2:45PM)
Choose one
LSC Little Ocean Explorers Prep- Attendance (Choose days of attendance)
Surf and Science Academy (8:30AM-10:45AM)
Choose one
Surf and Science Academy- Attendance (Choose days of attendance)
Morning Enrichment Add On (9:15AM-10:45AM)
Choose one
Morning Enrichment- Attendance (Choose days of attendance)
Morning Beach Program Add On (9:15AM-10:45AM)
Choose one
Morning Beach Program- Attendance (Choose days of attendance)
Payment Options
Will you be using charter funds?
Which Charter School are you contracted with?

My Products

Registration Fee: Surf

Programs: Surf & Science Academy

$165.00 Quantity

Registration Fee: Learning Center

Programs: Learning Center or Little Ocean Prep

$165.00 Quantity

Total

Payment Methods
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year

Cancellation Policy: Little Surf Co. Institute Programs
*Little Surf Co. reserves the right to cancel a contract or remove a child/family from our program at any time, exercising discretion to ensure the optimal learning environment for all participants.
Date Signed

MonthDayYear
Date
Parent/Guardian Signature
Should be Empty:

Little Surf Co. Institute 2026/2027 School Year Registration and Payment Form

Student Questionaire

Program Registration Selection

My Products*

My Products