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501-I South Reino Road Ste# 285
Newbury Park, CA, 91320
USA

805.991.AWOW

WHO ARE WE?

A Walk On Water is a family of watermen sharing the therapeutic powers of the ocean with those in need. AWOW's primary goal is providing relief to families of children with special needs. We are a humanitarian and environmentally conscious organization with an eye on sustainability.

 

WHAT DO WE DO?

AWOW provides water therapy through guided surf instruction or “surf therapy”.  Surfing's physical and repetitive nature produces a therapeutic effect and helps build self confidence.  Children experience the true stoke of surfing and a renewed sense of accomplishment as family and friends cheer them on from the beach.  Often shadowed by their special needs brother or sister siblings are also encouraged to participate.  Our surf events focus on both the athletes and their families, who are treated to a well-deserved day of relaxation and pampering.

www.awalkonwater.com

 

ATHLETE SIGN UP

Fill out the information below to sign up your child as an athlete with A Walk On Water. Please fill out a form for all surfers interested in surf therapy through AWOW, including your children with special needs and any siblings.

The following information is required to complete the signup process.  Please fill out all information to the best of your ability.  After your information has been processed, you will receive an email with information on future events.  This will serve as confirmation that your child is registered.  Please note that details are emailed out approximately 4 weeks prior to an event.  If you have any questions, please contact us at info@awalkonwater.com.

Full Name of Participant *
Full Name of Participant
Birth Date of Particpant *
Birth Date of Particpant
Guardian Name #1 *
Guardian Name #1
Guardian Name #2
Guardian Name #2
Address *
Address
Primary Phone # *
Primary Phone #
Cell Phone # *
Cell Phone #
Emergency Contact *
Emergency Contact
Emergency Contact Phone # *
Emergency Contact Phone #
On Any Medications?
Any Allergies
Participants Last Tetanus Shot
Participants Last Tetanus Shot
Physician Name
Physician Name
Physician Phone #
Physician Phone #