Name

E-Mail Address

Birthday

Passport / ID

Phone

How did you find out about NOMB Surf?

Address

Instagram / Facebook

Date & amount of coachings

Do you need any equipment? Do you need any equipment? I bring my own equipment (wetsuit & board) I need a surfboard I need a wetsuit

Choose your surf level Choose your surf level1 Beginner (No experience or trial surf day)2 Experienced Beginner (Take-Off, Surfing in White Wash, Going Straight, Maybe first Turns)3 Intermediate (Paddling, Small Green Waves, Changing Directions in Waves)4 Experienced Intermediate (Good Positioning, Turns, Surf along the face of the wave, Duckdives)5 Advanced (Long experience, confidence in the Line-Up, Bottom and Top Turns, Cutback in the making)

Do you suffer from any medical condition (allergy, surgery, illness etc) we should consider?

Emergency contact or next to kin (name & phone number)

Any comments or questions?

Terms & Conditions & Booking Policy Terms & Conditions & Booking Policy I have read and understood NOMB Surf´s terms & conditions and booking policiy and agree to them.

Medical Insurance Medical Insurance I hereby declare that I am responsible of having sufficient insurance to cover this coaching.

Photo Use Photo Use I agree that any pictures & videos which have been recorded during the trip may be duplicated, forwarded and be used by NOMB Surf free of charge in audiovisual and online media for documentation and marketing purposes.

I want to be part of the surfteam I want to be part of the surfteam I officially book my space the trip selected above (binding).

'Believing in the positive impact of surfing' - NOMB Changes 'Believing in the positive impact of surfing' - NOMB Changes I would like to support your NGO NOMB Changes with a donation

Amount (€)