Application - Maui Surfer Girls

Full Name*
Email Address*
Phone*
Date of Birth*
Date Format: MM slash DD slash YYYY
Address*
Street Address City State ZIP Code
Parent Name*
Parent Phone Number*
Which Week are you interested in?*
What is your ethnic background or heritage?
Why do you want to attend Maui Surfer Girls?*
What strengths and interests can you contribute to our surf camp community?*
How have you helped others in your community or family and how have you been a role model for others?*
How will you pay it forward after receiving this opportunity to attend our girls surf camp?*
Phone
This field is for validation purposes and should be left unchanged.