Official Entry Form

Participant Name: |
Address: |
City: |
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Zip: |
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Under 18: | Yes No If yes, have parent complete consent form.
PHOTO RELEASE: All photos submitted to this contest are property of Amfibian, LLC. Photos may be used by Amfibian, LLC for any and all advertising materials. Photos WILL NOT be returned.
PARTICIPANT RELEASE/LIABILITY WAIVER: Amfibian, LLC holds NO responsibility for any and all individuals who enter this contest. Any and all individuals are completely responsible for any and all injury/injuries and/or death that may occur to themselves and/or others while involved in any activities related to this contest including, but not limited to, attempting to surf big waves. Please surf/enter at your own risk. Check box below to agree to these terms.
I agree to the Participant Release/Liability Waiver
I have read the rules and regulations
| All Fields Are Required

We take your privacy very seriously. The information collected here is kept strictly confidential. None of your information will be shared, sold or otherwise distributed.