[Imported Form] Surf camp application

Name and surname*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Date of birth*
E-mail*
Phone Number*

Area CodePhone Number
ID or PASSPORT number
Choose your destination: Fuerteventura or Portugal*
Arrival date*
Departure date*
Surf school:
If you have surfing experience, how many days have you surfed until now?
Do you have any disease from the list: heart diseases, epilepsy, asthma, allergies or similar:

YesNo
If you have any, please define your disease:
I want further info about GoOpti low-cost transportation to / from the airport*

YesNo
How did you find out about KoHoLa surf camps? (posters / leaflets, through a friend, Google, Facebook, other on Internet, somehow different - how?)*
General terms Word document download
Should be Empty: