Wednesday at Eastern Hills Church - September 3rd at 10:15am

1

E-mail* This field is required.

example@example.com

2

Adult Name* This field is required.

First Name

Last Name

3

Children's names and ages* This field is required.

4

Phone Number* This field is required.

Area Code

Phone Number

5

Date

6

Please choose the class time that works for you. * This field is required.

10:15am

7

How would you like to pay for class?* This field is required.

Venmo @feelingsrock

Paypal info@feelingsrock.com

cash day of class

Please check my prepaid classes

8

Class is $15 per class or $60 for 5 classes* This field is required.

$15 for one class

$60 for 5 classes

I am prepaid

9

I sometimes take pictures in class and post them on my social media. There are so many sweet moments I like to capture! Are you OK with your child being in pictures?* This field is required.

YESNO

10

Do you want to receive information about upcoming events?

YESNO