EVENT ENTRY FORM
2015 Event Schedule: #1 May 17 | #2 July 18 | #3 July 26 | #4 Aug 8 | #5 Oct 4
Event #: ______________
Age as of Jan 1 2016:_____________
Name: __________________________________________________________ Date of Birth:____________________
Mailing Address: _________________________________________________________________________________
City: _____________________________________ State: __________________ Zip: ________________________
Phone: (______)__________________ Email: _________________________________________________________
$20.00 for 1st Division | $10.00 Each Additional Division
*Do Not Enter Any Divisions You Will Be Older then As Of January 1 of 2016. Surfing Up Divisions is Allowed.
Shortboard Divisions
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Menehunes U12 (11 & Under, M/F)
Boys U14 (13 & Under)
Boys U16 (15 & Under)
Junior Men U18 (17 & Under)
Men (18-29)
Masters (30-39)
Senior Men (40-49)
Legends (50 & Over)
Grand Legends (60 & Over, M/F)
Girls U14 (13 & Under)
Girls U16 (15 & Under)
Junior Women U18 (17 & Under)
Women (18-34)
Ladies (35 & Over)
Open Shortboard (All Ages, M/F)
Longboard Divisions
SUP
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Open SUP
(All Ages, M/F)
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Micro-Mini
(Under 10, M/F)
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Bodyboard Divisions
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Micro-Mini-Push-In
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*No Membership Required
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Menehune Longboard U14 (13 &
Under, M/F)
Junior Longboard U18 (17 & Under)
Mens Longboard (18-34)
Masters Longboard (35-49)
Legends Longboard (50 & Over)
Junior Womens Longboard U18 (17 &
Under)
Womens Longboard (18 - 34)
Ladies Longboard (35 & Over)
Menehune Bodyboard
(13 & Under, M/F)
Open Bodyboard
(All Ages, M/F)
* Competitors can surf in as many divisions as you want It is ok to surf up divisions if you would like.
Please make your check payable to:
ESA North Florida District
TOTAL AMOUNT: $___________________________
All Contestants Must Complete Entry and Release Form
Please Support our
Local Sponsors
CONTESTANTS SIGNATURE:________________________________________________
FOR CONTESTANTS UNDER 18 YEARS OF AGE:
I HEREBY CERTIFY that I am the parent or guardian of the surfer named above, and do hereby give my permission without reservation and with full
understanding and comprehension of the foregoing agreement to hold the aforementioned organization and governmental entities harmless any and
all liabilities including any such injuries which are alleged to have occurred as a result of negligent failure of ESA officials, judges, and directors to
properly supervise contestants in the course of competition.
SIGNATURE OF PARENT OR GUARDIAN:______________________________________
Marker 32
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