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Surfrider Spirit Sessions Mentee Application
Mahalo for referring a youth to become a part of our Surf Ohana!
The first step is to fill out this application.
If accepted, you may need to submit a few additional basic enrollment materials.
Youth are accepted based on a first come, first serve basis, youth qualifications and referring source (references) and available program space.
We'll review your application and reply within 72 business hours.
Programming - Mentee Application Rev 4.5 Apr 2024
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* Indicates required question
What session are you registering for?
*
Spring 2024
Summer 2024
Fall 2024
First Name
*
First Name of Applicant
Your answer
Last Name
*
Last Name of Applicant
Your answer
Nickname
*
If you have a nickname that you prefer to go by, write that in this box
Your answer
Birthdate
*
MM
/
DD
/
YYYY
Gender
*
Male
Female
Prefer not to say
Other:
Required
Email Address
*
List email address for parent/guardian. This is used to communicate program information
Your answer
Home Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
Phone number (Youth)
*
If the youth participant has a phone number, please list it here. Mark NA if there is no phone number for the youth participant.
Your answer
Parent/Guardian Contact 1 - Name (First and Last)
*
Name of main point of contact for youth
Your answer
Parent/Guardian Contact 1 - Relationship to Youth
*
Parent
Grandparent
Auntie/Uncle
Legal guardian
Other:
Required
Parent/Guardian Contact 1 - Phone number (1)
*
List phone number for parent/guardian
Your answer
Parent/Guardian Contact 1 - Phone number (2)
If there is an additional phone number for this contact, please list here.
Your answer
Is Contact 1 a Legal guardian who can sign consent forms?
*
Yes
No
Parent/Guardian Contact 2 - Name (First and Last)
*
Name of additional point of contact for youth
Your answer
Parent/Guardian Contact 2 - Relationship to Youth
*
Parent
Grandparent
Auntie/Uncle
Legal guardian
Other:
Required
Parent/Guardian Contact 2 - Phone number (1)
*
List phone number for parent/guardian
Your answer
Parent/Guardian Contact 2 - Phone number (2)
If there is an additional phone number for this contact, please list here.
Your answer
Is Contact 2 a Legal guardian who can sign consent forms?
*
Yes
No
If no legal guardian is listed, please give name, phone number and email for a legal guardian who can sign consent forms
*
Mark NA if this does not apply
Your answer
Age
*
Your answer
Are translation services needed for parents/guardians?
*
If so, please mark which language(s) translation is needed
No Translation Services Needed
Chuukese
Hawaiian
Marshallese
Samoan
Spanish
Tagalog
Tongan
Other:
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