If you are interested in attending a clinic, please fill out the form below. Clinics are open to most veterans, regardless of the nature of your injury.

Name *
Name
Phone *
Phone
Please provide Current city and state of residence
Date of Separation if Retired or Discharge
Date of Separation if Retired or Discharge
Date of Injury *
Date of Injury
Will you require medical care or attention during the clinic? *
Have you ever been sailing before? *
Have you ever surfed before? *
Have you ever done yoga before? *
Has your injury or disability affected you being able to do this? *