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XTREME HIPHOP WITH SAM
Class Registration
7
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1
First and Last Name
First Name
Last Name
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2
Gender
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This field is required.
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Male
Female
N/A
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Male
Female
N/A
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3
Age
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Under 16
Age 16-21
21+
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Under 16
Age 16-21
21+
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4
List of Classes
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FRIDAY OCTOBER 4TH -- HEALTHY HUSTLE FITNESS 645PM
-------
Tuesday Oct 8th-- 7pm
Tuesday Oct 15th -- 7pm
Tuesday Oct 22nd -- 7pm
Tuesday Oct 29th -- 7pm
Saturday, Oct 12th -- 830AM
Saturday, Oct 19h -- 830AM
Saturday, Oct 26th -- 830AM
Saturday, Nov 2nd —830AM
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Please Select
FRIDAY OCTOBER 4TH -- HEALTHY HUSTLE FITNESS 645PM
-------
Tuesday Oct 8th-- 7pm
Tuesday Oct 15th -- 7pm
Tuesday Oct 22nd -- 7pm
Tuesday Oct 29th -- 7pm
Saturday, Oct 12th -- 830AM
Saturday, Oct 19h -- 830AM
Saturday, Oct 26th -- 830AM
Saturday, Nov 2nd —830AM
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5
Best Contact Number
In the event of any class changes
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6
Email
If you like to be updated on upcoming classes, events, and certifications! (Optional)
example@example.com
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7
My Products
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My Bag
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Great Product Name
$20
Quantity:
1
Size:
Small
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Great Product Name
$20
Quantity:
1
Size:
Small
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Great Product Name
$20
Quantity:
1
Size:
Small
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Great Product Name
$20
Quantity:
1
Size:
Small
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ORDER SUMMARY
Total cost
USD
LUNA FITNESS GUEST ($15)
TUESDAYS 7PM AND SATURDAYS 830AM
$
15.00
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LUNA FITNESS MEMBERS ONLY ($10)
MEMBER EXCLUSIVE PRICING - Member ID # required at class signup
$
10.00
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Member ID:
Member Tuesdays (LUNA MEMBERS ONLY)
Tuesdays included with your Luna Fitness Club membership!
$
Free
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One To One Session
One hour 1 to 1 training. Contact in advance to schedule session.
$
25.00
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Hustle Fitness
$15 payment to @HEALTHYHUSTLEFITNESS
$
Free
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Payment Methods
Credit Card
First Name
Last Name
Cash App
After submitting the form, you will be redirected to the Cash App Pay to complete the payment process.
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