Community Course Registration
Please fill your details below to enrol in your chosen course.
Student Name
*
First Name
Last Name
Mobile Number
*
Please enter a valid phone number.
E-mail
*
example@example.com
Gender
*
Please Select
Female
Male
Non-binary
Prefer not to say
Please select your gender
Suburb of Residence
*
Street Address
Street Address Line 2
Suburb
State
Postal / Zip Code
Year of Birth
*
Please type your year of birth
Country of Birth
Emergency Contact Name
Emergency Contact Mobile
*
Please enter a valid phone number.
Do you have any health concerns, a pre-existing medical condition, are pregnant, or have had a recent injury that may impact your participation in this class?
*
Yes
No
Choose your course and process payment below
*
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Monday Yoga
with Lynette
$
138.00
AUD
Quantity
1
Item subtotal:
$
0.00
AUD
Tuesday Yoga
with Tori
$
154.00
AUD
Quantity
1
Item subtotal:
$
0.00
AUD
Stay Fit/Live Fit
with Allan
$
100.00
AUD
Quantity
1
Item subtotal:
$
0.00
AUD
Wednesday Yoga
with Anna
$
154.00
AUD
Quantity
1
Item subtotal:
$
0.00
AUD
Tai Chi
with Lilei
$
130.00
AUD
Quantity
1
Item subtotal:
$
0.00
AUD
Rhythm & Movement
with Dijana
$
145.00
AUD
Quantity
1
Item subtotal:
$
0.00
AUD
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Would you like to stay in the loop?
*
Yes, please send me helpful opportunities about courses,news and opportunities (email/SMS).
No thanks, I don’t want to receive marketing messages(please note you will still receive communication about current enrolments).
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