EK Youth Fishing Homeschool Program Registration Form

EK Youth Fishing Homeschool Program Registration and Waiver Packet

Join our hands-on homeschool program where kids build confidence through fishing, boating, kayaking, and outdoor learning. Our program is designed to teach real-life skills through engaging, age-appropriate instruction both on land and on the water. Location: Tradewinds Park, Time: 9:00 AM – 1:00 PM, Sessions run Tuesdays or Fridays seasonally (Winter, Spring, Summer, Fall). EK Youth Fishing also offers birthday party packages, private lessons, semi private lessons with groups of 2+ and pop up EK Youth Fishing program classes. Now also offering four week Adventure Series classes during the months of August through September.
Select Program Days / Service of interest
Select Program
How did you hear about EK Youth Fishing Homeschool Program?
⚠️ Your spot is only secured once payment is completed.
Step Up for Students Instructions Select Providers “In-Person” → “Physical Education” → Vendor: Extreme Kayak Fishing
EK Youth Fishing may take photos or videos during program activities for educational and promotional purposes
Children Participating in EK Youth Fishing

(Click Add New to include additional children)
Please enter information for all children participating below
Parent/Guardian Contact Information

Please provide the parent or legal guardian's contact details.
Parent/Guardian's Full Name

First NameLast Name
Parent/Guardian's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Relationship to Participant
Parent/Guardian's Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Parent/Guardian's Email Address
example@example.com
Authorized Pickup Person (if different from Parent/Guardian)

First NameLast Name
Authorized Pickup Person Phone
Please enter a valid phone number.Format: (000) 000-0000.
Authorized Pickup Person Relationship to Participant
Emergency Contact Information

Provide details of an emergency contact other than the parent/guardian.
Emergency Contact Name

First NameLast Name
Relationship to Participant
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Special Requirements

Let us know if the participant has any special needs or requirements.
Please specify any special requirements or accommodations needed for the participant.
Program Shirt Size (New Participants Only) New participants receive one program shirt. Returning participants who already received a shirt do not receive an additional shirt
Program Includes:

• 8 sessions of fishing instruction (land & water)

• All equipment and safety gear

• Kayak fishing & Jon boat experience

• Special guest teachers & fishing skills building

• Rod setup, knot tying and casting techniques

• Fish handling and safety education

• Conservation Lessons

• Team challenges and outdoor games

• Hands-on STEM learning integration

• Keepsake Photo

• End-of-session awards

• Official EK Youth Fishing program shirt for new participants and Straw Hat
Parent/Guardian Agreement & Waiver Acknowledgement

Participation includes outdoor and water-based activities that involve inherent risks including fishing, kayaking, boating and wildlife encounters.
Parent/Guardian's Signature
Parent/Guardian's Full Name

First NameLast Name
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Broward County Liability Waiver (Required) This form only needs to be completed and emailed to maria@extremekayakfishing.com once per year, per family. If you have already submitted a waiver this year, you may skip this step.Click HERE to view the Waiver
How will you be paying for this program?

My Products

EK Youth Fishing Homeschool Program

$650.00 Quantity

EK Youth Fishing Homeschool Program (one day drop-in)

$100.00 Quantity

Single 2 Hour Fishing Lesson (up to 2 Kids)

$350.00 Quantity

Single 2 Hour Fishing Lesson (up to 5 Kids)

$450.00

Adventure Series Monthly (four classes)

$595.00

Adventure Series (one day drop-in)

$175.00 Quantity

Total

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EK Youth Fishing Homeschool Program Registration and Waiver Packet

Children Participating in EK Youth Fishing

Parent/Guardian Contact Information

Emergency Contact Information

Special Requirements

Parent/Guardian Agreement & Waiver Acknowledgement

My Products

Credit Card