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INSCRIPTION FORM 2024
Escuela de Tabla Etnia Perú
www.etniaperu.com
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* Indicates required question
First Name/ Nombre
*
Your answer
Last Name/Apellidos
*
Your answer
Date of Birth/Fecha de cumpleaños
*
MM
/
DD
/
YYYY
Address/Dirección
Your answer
Cellphone number/ Celular
*
Your answer
E-Mail
*
Your answer
Height/Estatura
*
Your answer
Weigth (in kg)/ peso
*
Your answer
Surf Level/ nivel de surf
*
Beginner/Principiante
Intermediates or Advanced/avanzado
Packages/paquetes
*
Light group lesson (1 class / week, 4 class / month); cost: S/. 480
Regular group lesson (2 classes / week, 8 classes / month); cost S/. 799
Single class, (group lesson) cost S/. 120
Private class; cost S/.150
Days
*
Monday/Lunes
Tuesday/Martes
Wednesday/Miercoles
Thursday/Jueves
Friday/Viernes
Saturday/sabado
Sunday/Domingo
Required
Hours
*
06:00am - 07:30am
09:00am - 10:30am
11:00am - 12:30pm
Month(s) of class
Enero
Febero
Marzo
Abril
Mayo
Junio
Owns a wetsuit/tiene wetsuit?
Yes/si
No/No
Clear selection
Can swim/sabe nadar o flotar?
*
Yes
No
Diseases/ alguna dolencia?
Your answer
Comments/Comentarios
Your answer
CONTACT DATES IN CASE OF EMERGENCY/En caso de emergencia llamar a:
Name of contact person/nombre del contacto
*
Your answer
Cellphone/celular
*
Your answer
TERMS OF SERVICE AGREEMENT/Términos de nuestros servicios
The following link provides the terms of service agreement:
https://drive.google.com/file/d/0B1RwlJhJRNkHeVpGMTVDOVJOVG8/view
*
By accepting, I confirm that I have read and understand the terms of contract./Confirmo y acepto los términos de servicios
Required
BANK DETAILS/Detalles de pago
The payment can be done to our BCP account
Soles Account: Mi número de cuenta BCP Soles es 194-21106001092
cuenta interbancaria es 00219412110600109295 send voucher whatsapp 998110006
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