Name:

Email: (very important, without it we can’t contact you)

Street address:

City and Country of residence:

Telephone:

Fax

Booking date for your lesson:

Day123456789101112131415161718192021222324252627 28293031      MonthJanFebMarAprMayJunJulAugSepOctNovDec      Year2008200920102011 2012

Do you want a morning or afternoon lesson?

 Morning        Afternoon

Type of lesson:

  Children’s Special  -  US$29.00

  Aloha Beginner’s Course  -  US$39.00

  Shaka Full Day Course  -  US$75.00

  Hang Ten 3 Day Course  -  US$179.00

  Professiona Private Lessons  -  US$50.00 per hour

Number of persons for group lesson:

 1    2    3    4    Group lesson

If group lesson is 4 or more persons, please specify in the box below:

If booking a children’s lesson, please give number and age of children:

Special requests or other instructions, please specify in the box below:

Please be sure to fill out all information above and don’t forget to include your valid email address, we can’t contact you without it.

All personal info is 100% confidential.

Once all info is checked, accurate and complete, click the submit button.