Adult Yoga Class Registration Form

Adult Yoga Class Registration Form

$10 a Class or pay in advance 4 classes for $35. You must register up to 2 hours before 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 23rd 6pm-7pm September 30th 6pm-7pm October 7th 6pm-7pm October 14th 6pm-7pm October 21st 6pm-7pm October 28th 6pm-7pm November 11th 6pm-7pm November 18th 6pm-7pm December 2nd 6pm-7pm December 9th 6pm-7pm December 16th 6pm-7pm January 6th 6pm-7pm January 13th 6pm-7pm January 20th 6pm-7pm January 27th 6pm-7pm February 3rd 6pm-7pm February 10th 6pm-7pm February 17th 6pm-7pm February 24th 6pm-7pm March 3rd 6pm-7pm March 10th 6pm-7pm March 17th 6pm-7pm March 24th 6pm-7pm March 31st 6pm-7pm April 7th 6pm-7pm April 21st 6pm-7pm April 28th 6pm-7pm May 5th 6pm-7pm May 12th 6pm-7pm May 19th 6pm-7pm May 26th 6pm-7pm June 2nd 6pm-7pm
Emergency Contact
Name

First Name Last Name
Phone Number

Area Code Phone Number
Payment is due at the start of each class. Payments can be made by cash or checks. Make checks payable to Contemporary Academy of Dance. If paying 4 classes for $35, you must use by June 2022.

Bring a yoga mat and wear comfortable clothes that you can move in.
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
Should be Empty:

Now create your own JotForm - It's free! Create your own JotForm

Adult Yoga Class Registration Form

Emergency Contact

Liability Release