Full Name *

Mailing Address *

City *

State

Country *

Zip Code

Date of Birth (MM/DD/YY) Select Date *

Profession

Gender Select Gender Male Female *

Passport Number *

Issuing Country *

Country of Residence

Expiration Date (MM/DD/YY) Select Date *

Email *

Phone (work)

Phone (home) *

Cell Phone

Contact Name

Relationship

Telephone

Medical Concerns

Please select 1 or 2:

Surf

Surfing Proficiency Beginner (no experience) Beginner (some experience) Intermediate Advanced

Spanish

Spanish Proficiency Beginner (no experience) Beginner (some experience) Intermediate Advanced

Poi

Poi Proficiency Beginner (no experience) Beginner (some experience) Intermediate Advanced

Yoga

Scuba Certification

Number of Weeks: *

Course Start Date (must coincide with Schedule) Select Date *

Roommate Request

Room Preference Please select Shared Room Private Room *

Promotional Code

How did you hear about us? Please select Sponsored Search Organic Search Facebook Myspace Other Website Flyer Brochure Newspaper or Magazine Friend Other *

If By Search, Keywords Used For Search

Additional Comments

Pickup is not included in price but can be arranged from San Jose or Playa Tambor airports.  If you would like us to arrange pickup, please provide the following and we will contact you shortly with further details:

Airport

Flight Number

Airline

Date of Arrival Select Date

Time of Airrival

Applicants must be 18 years of age by date of arrival. Montezuma Surf School (MSS) makes every effort to ensure the safety of its students. Our first day together, we hold an informational seminar, giving you traveling tips to help guard against the dangers of personal injury or theft in the region. That said, MSS is not responsible for any injury, property damage or loss which might occur to students while attending any MSS activity or while traveling in or around Costa Rica.

I agree to the Terms and Conditions as stated above. *