Adult Yoga Class Registration Form

Adult Yoga Class Registration Form

Classes Begin September 13th - $10 a Class or pay in advance for 4 classes for $35 You must register prior to each class to attend.
Name *

First Name Last Name
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number *

Area Code Phone Number
Email *
example@example.com
Any Medical Conditions, Allergies or Special Needs that we should be aware of *
Classes Enrolling in

September 13th 6pm-7pm September 20th 6pm-7pm September 27th 6pm-7pm October 4th 6pm-7pm October 11th 6pm-7pm October 18th 6pm-7pm October 25th 6pm-7pm November 1st 6pm-7pm November 8th 6pm-7pm November 15th 6pm-7pm November 22nd 6pm-7pm November 29th 6pm-7pm
Emergency Contact
Name

First Name Last Name
Phone Number

Area Code Phone Number
Payment is due prior to each class. If paying for 4 classes for $35, you must attend classes within 60 days of payment.
All Payment information and Policies are listed on our website.

For public relation purposes photos and videos may be taken of you. If you object to the use of these photos or videos you must notify Contemporary Academy of Dance in writing.
Liability Release
Contemporary Academy of Dance is not liable for any injury, damage or loss of property. I release Contemporary Academy of Dance from all liability, injury, damage or loss of property. I have read and agree to the payment terms, fees, and policies listed on our website.
Signature *

Clear
Date *

Month Day Year
Date
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Adult Yoga Class Registration Form

Emergency Contact

Liability Release