Lowfire Trip Registration
 Salinas Grandes, Nicaragua 2025: December 5th-12th
Cost per Person (excluding flights): $1200
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Section 1: Personal Information
Full Name *
Email *
Age *
Gender *
Home Address *
Section 2: Emergency Contact
Emergency Contact Name *
Relationship *
Emergency Contact Phone Number  *
Section 3: Retreat Specific Questions
How did you hear about Lowfire? *
Why are you interested in this trip? *
What are you hoping to gain from this experience? (Optional)
Have you attended similar trips before? *
Describe your current relationship with faith/spirituality. (Optional)
Section 4: Health and Physical Information
Do you have any health concerns, allergies, or physical limitations we should be aware of?
 *
Are you currently taking any medications?
 *
Do you have any dietary restrictions or preferences?
 *
Section 5: Adventure & Skill Level
Surfing Experience
 *
Activities You're Comfortable With
 *
Required
Section 6: Travel Information
Do you have a valid passport that does not expire before May 2026?
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Passport Country of Issuance
 *
Full Legal Name as it appears on your passport
 *
Are you willing to independently book your flight to Nicaragua, or will you need assistance?
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What airport do you plan to depart from? *
Do you plan on purchasing travel insurance for this trip?
 *
Have you traveled internationally before? *
Are there any cultural, legal, or travel concerns we should be aware of regarding your nationality or travel history? If yes, please explain. 
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Section 7: Acknowledgements
I understand that I am responsible for my trip cost. ($1,200 + airfare)
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Required
I agree to sign a liability waiver prior to participation.
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Required
I understand I am responsible for ensuring I meet all travel requirements, including a valid passport and any entry requirements for Nicaragua.
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Required
I understand that participation may include (optional) physically demanding activities and that I am responsible for disclosing any health conditions.
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Required
I agree to follow all safety instructions, respect local customs, and behave in a way that reflects the heart and mission of Lowfire.
 *
Required
Section 8: Additional Information
Is there anything else you'd like to share or questions you may have?
Submit
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