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Contact Information First Name Last Name Address City St. ZIP Phone: Fax: E-mail:
Travel Information Month Day and year you plan to visit Maui Ever been to Maui? Yes No Preference of food? Do you want help with airfare and accommodations? Yes No Do you have medical coverage? Yes No Last Tetanus Shot
Surfing Information On a scale of 1 - 10 what rating would you give your self as a surfer 1 2 3 4 5 6 7 8 9 10 Stance: Are you goofy or regular foot? (Goofy stands on a skateboard or surfboard with the right foot forward) regular goofy What wave sizes can you surf? 1-3 feet 3-6 ft 6-10 ft. 10 ft plus Board size you like to use 6 ft - 6'6 6'8 - 7'2 ft Minitanker LongBoard Not Sure Your Weight & Height? Additional Comments or questions?
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©John Nauka DBA Kai Nalu (ph)808.579.9937 (fax)808.579.9937 nalu@maui.net 536 Kahua Pl Paia Hi 96779