We Are Ocean Camp Application - Newport Aquatic Center

File(Required)

Max. file size: 3 GB.

Upload a current photo for yourself

Phone(Required)

Email(Required)

Birthday (mm/dd/yyyy)(Required)

Instagram Handle (if applicable)

Emergency Contact Phone(Required)

Occupation(Required)

How did you hear about the program?(Required)

Please describe your experience with cancer(Required)

Current Cancer Status

Are you on medication for cancer treatment currently?(Required)

How long have you been in remission? If Applicable

Why do you want to go to a NAC | WAO Camp?(Required)

What is your comfort level in the ocean? Can you swim or do you need some assistance? We have you covered no matter what.(Required)

Do you have any physical restrictions and/or special needs?(Required)

On a scale of 1-5: What is your swim level?

On a scale of 1-5: What is your surf ability level?

On a scale of 1-5: What is your What is you hiking level?

Do you have any dietary preferences or requirements? Please clearly share, we will do our best to accommodate.(Required)

How would you describe your physical health at the moment? Please clearly share your current level of fatigue.(Required)

How would you describe your mental health at the moment?(Required)

Wetsuit Size(Required)

Shirt Size (In Mens)(Required)

Shoe Size(Required)

NAC / WAO Links