TWSA Sign Up - Life Rolls On Foundation

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TWSA Registration
They Will Surf Again
Registration for SEPTEMBER 11 TWSA-La Jolla is now CLOSED.
First Name:*
Last Name:*
Birth Date:*	(mm/dd/yyyy)
Email:*
Company Name:
Job Title:
Address Line 1:*
Address Line 2:
City:*
State:*
ZIP/Postal Code:*
Cell Phone:*
Phone:*
I would like to participate in TWSA:*	Volunteer on land Volunteer in water I am a surfer with a disability Videography/Photography
If you selected to volunteer in the water, please indicate your preference:*
Have you participated in a TWSA event in the past?:*
Have you ever been a TWSA team leader?:*
If you would like to participate as a surfer with a disability - please describe your experience level and special needs:
Do you have a Spinal Cord Injury?:*	Yes No I know someone who does
Give us some details to the above answer:
What specific skill set - knowledge or perhaps personal connections do you have that may be used to further our cause?:
Have a Message for LRO?:

Release Acknowledgment
Please complete this release form which you may customize online. Please print it, sign it (two places for signature) and fax it to (424) 219-9441 or scan and email it to Sarah@LifeRollsOn.org. You will only have to complete it once per year. REGISTRATION IS NOT COMPLETE WITHOUT A WAIVER.
Release of Liability and Media Release Form:*	Final Online Waiver Form.pdf Update Remove
Waiver Acknowledgment:*

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TWSA Registration