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Please fill out the form completely. If you do not have a copy of your DD214 (retired or separated) or Active Duty Military ID, we will not approve your application. You will also need a copy of your VA Benefits Summary Letter (total percentage). Please do not send your Retired Military ID or your VA ID card.
Mahalo.
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Indicates required field
Name
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First
Last
Age
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Ethnicity
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Select one
American Indian or Alaska Native
Asian
Black or African American
Hispanic or Latino
Native Hawaiian or Other Pacific Islander
White
Other
Gender
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Birthdate
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Phone
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Address
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Line 1
Line 2
City
State
Zip Code
Country
Email
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Service
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Army (includes Nat'l Guard)
Navy
Coast Guard
Marines
Air Force
Rank
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Length of Services (Yrs)
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Injury or Disability (PLEASE READ FULLY! IMPORTANT!! — What Injuries have you sustained that make it difficult to surf a normal surf board. Please DO NOT enter “yes” or your disability rating. We want to understand the injury/disability that limits your surfing to ensure we can provide the best solution. DO NOT WRITE YOUR DISABILITY RATING)
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Please let us know what your injury or disability is.
Surf
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Never surfed
I recently completed a surf clinic (within the last 6 months-Balboa Hospital, Access Surf, Op Surf, Warrior Surf, JMMF, AMP Surf, etc)
I am able to ride the whitewater of a wave
I am able ride a wave that is knee to waist high (riding the face of the wave)
I am able to ride a wave that is waist to head high (riding the face of the wave)
I am able to ride a wave that is head high plus
I have my own equipment but I would like to surf with fellow veterans
Level of experience
Do you use Instagram? Please add your handle
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Types of Equipment Desired
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Surfboard
Bodyboard
Handplane
Wetsuit
Other
What conditions do you usually surf?
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Where do you usually surf?
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How often do you surf?
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Once a week
2 times a week
3 times a week
4 times a week
5 times a week
6 times a week
7 times a week
Once a month
2 times a month
3 times a month
Once every 2 months
Once every 3-6 months
Once a year
I surf once in a blue moon
I've never really surfed before
Why do you need our equipment? I.e., need custom buoyancy, need custom handles, or custom re-enforcement?
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What kind of equipment do you usually use?
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Height
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Weight
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Are you willing to travel to San Diego to surf demo equipment in order to refine the process? If approved and needed, One More Wave will cover the expense
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Yes
No
Please feel free to let us know what surfing and surf therapy means to you.
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How did you hear about us?
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Lastly, are you comfortable with taking pictures with your new equipment once it is received?
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Yes
No
Please attach your DD 214 or Active Duty ID (No retired Military ID please)
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Max file size: 20MB
Please attach your VA Benefits Summary Letter (No VA ID cards please)
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Max file size: 20MB
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