Online Yoga Class Registration Form

Online Yoga Class Registration Form
Name*

First NameLast Name
Email*
example@example.com
Phone Number

Area CodePhone Number
Date of Birth

MonthDayYear
Date
Class

MonthDayYear
Date
By checking here I verify that I have completed and signed the New Client Waiver for Mindfully Balanced.
The New Student Waiver can be found here and only needed to be completed once.
To finilize your registration please venmo your desired donation amount to @Heidi-Walter-1. A link for the class will then be sent via email.
Should be Empty: