::: WELCOME TO WAKE COACH :::

Please register yourself for any of the wake programs below:

First and Last Name:

Address:

Program you are registering for:

Private Coaching Pro Development

After School Ride Club Corporate Events

Summer Jam Day Camps($500) Add Photo Package ($45) Add Pick Up Drop Off ($75)

Choose Your 2008 Summer Jam Camp

June 23rd-27th July 21st-25th August 11th-15th

PLEASE NOTE: Because of the limited space we have in our day camps a $100 non-refundable deposit will be charged to your credit card with in 24hrs of your registration. Your remaining balance will be charged one week prior to camp starting. You will receive an email reminder 24hrs before your credit card is charged for the remaining balance. If you have any questions please contact us. Thank you.

City:

State

Zip Code

Email:

Age:

Height:

Weight:

Shoe Size:

T Shirt Size:

XXL

Are you brining your own wakeboard?	YES	NO
Are you brining your own bindings?	YES	NO
Are you bringing your own lifejacket?	YES	NO
Are you bringing your own rope/handle?	YES	NO

How would you describe your riding level?
First time	Beginner	Intermediate	Advanced

Credit Card Authorization Form

Billing Address:

City:

State:

Zip Code:

First Name:

Last Name:

Card Number :

CVV Code :

Credti Card Type: Visa Mastercard

Signature:

' by typing your name you agree to pay the program amount'

WakeCoach Permanent Release of Liability

Whereas each of the undersigned individuals are desirous of using the services of WakeCoach, LLC as a wakeboarder and is doing so entirely upon his or her own initiative, risk, and responsibility. They are furthermore and duly aware of the risk and hazards inherent upon the use of the boat, trampoline, equipment, and dock.

Now therefore, in consideration of the use of the services of WakeCoach, LLC, whether with or without charge each of the undersigned individually, and/or as a representative of and on behalf of his or her spouse, child, or ward, hereby release WakeCoach, LLC and/or their agents, officers, servants, and employees of and from any liability, claims, demands, action, and causes of action whatsoever arising of or related to any loss, damage, or injury, including fatal injury sustained while using the services of WakeCoach, LLC, whether or not caused by the negligence or WakeCoach, LLC or its employees or by the failure of the equipment.

This release shall be binding upon the spouse, heirs, legal representatives, next of kin, executors, and administrators of each of the undersigned. gned.

In signing the foregoing release, each of the undersigned acknowledges and represents that he/she has read the foregoing release, understands and signs it voluntarily, that he/ she is at least eighteen (18) years of age

Helmets must be worn to hit all water obstacles. Life jackets must be worn at all times. Sliding a board will result in voiding a warranty. WakeCoach, LLC is not responsible for any damage to the board or injury to you.

Any and all d all cancellations for private lessons not within twenty-four hours (24) will result in billing
All payments must be rendered at the time of service unless prior arrangements have been made. made.

This document is implemented for the date of signature of the undersigned person/persons.

I have read and fully understand the foregoing release.

Print Name of Rider:	Today's Date:	Rider Signature, Parent or Legal Guardian:
Print Parent/Guardian Name	Address:
City:	State:	Zip Code:

Do you currently own a boat?	YES	NO
If yes, what type?
If no, can we send you more information?	YES	NO

How did you hear about us?
Internet	Yellow Pages	Friend	Sponsor	Other