SEA Program Participant Registration

Participant Information
Participant Full Name *
Participant Full Name
Participant Address *
Participant Address
Personal Flotation Device
If you have your own PFD that fits you, bring it with you to the program! (We will check sizing on the first day to make sure it fits just right!)
Do you have your own life jacket? *
For those without their own life jacket, we have a limited supply of PFD's of various sizes to make sure everybody will be covered!
Additional Questions
Do you have your own mask and snorkel? *
Contact Information
Parent/Guardian #1 *
Parent/Guardian #1
Parent/Guardian #2
Parent/Guardian #2
Primary Phone Number *
Primary Phone Number
Secondary Phone Number *
Secondary Phone Number
Emergency Contact Information
Emergency Contact Name *
Emergency Contact Name
Emergency Contact Phone Number *
Emergency Contact Phone Number
If the form doesn't submit when you click 'Complete Registration', scroll up to correct any fields that have errors.
 

Thank you for taking the time to complete this form to accompany your registration!  Registration is now complete, we will let you know we received your responses in a confirmation email.  If you have any additional questions or comments, feel free to email us: info@seasidesustainability.org

 

SEA 2017 Junior Leader Application

Name *
Name
Address *
Address
Primary Phone Number *
Primary Phone Number
Secondary Phone Number *
Secondary Phone Number
At least one reference required, which cannot be from a family member. Provide up to three references if you have them.
IF THE FORM DOESN'T SUBMIT WHEN YOU CLICK 'submit', SCROLL UP TO CORRECT ANY FIELDS THAT HAVE ERRORS.

Thank you for taking the time to complete this form to apply as a junior leader for this summer's SEA 2017!  Your application is now complete, we will let you know we received your responses in a confirmation email, and will contact you to set up a brief interview.  If you have any additional questions or comments, feel free to email us directly: info@seasidesustainability.org (please write Junior Leader SEA 2017 in the subject line of your email).