Highland Hustle Class Registration Form

Highland Hustle Class Registration Form

Register to participate in our exercise class (for ages 18 and above).
For information about schedules, registration and payment options, or other information about Highland Hustle (HH), please visit: Highland Hustle at NSOHD.

We respect your privacy. Any information you share will be kept confidential and used solely to support your participation, health and safety in HH classes.
Full Name*

First NameLast Name
Age Requirement:*

I am over 18 yearsI am between 12 and 18 yearsI am under 12 years
Minimum Age Requirement: You must be at least 18 years old to participate in Highland Hustle classes. Space permitting and at the discretion of the teacher, there may be some limited flexibility for participation of youth 12 to 16 years. If you are under 18 years and have received permission from NSOHD to register, please continue completing this form.

If you are under 18 years and have not received permission from NSOHD to register, please email us at nsohd@bell.net before completing this form!
Thank you for your interest in Highland Hustle but unfortunately, at this time, you are not eligible to register for these adult classes.
Home Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
Email Address*
example@example.com
Phone Number*
Please enter a valid phone number.
Date of Birth:*

MonthDayYear
Date
Health Information
Health experts suggest that you talk to your doctor before you start any exercise program. Please do not attend classes if you, or an immediate family member, are unwell or awaiting testing results or advice from a medical professional or public hearth authority.

PLEASE stop exercising immediately and inform the teacher if you experience pain, soreness, fatigue, shortness of breath, dizziness, lightheadedness, blurred vision, headache, nausea, sickness, illness, dehydration, excessive sweating, or any other discomfort.
Do you have any medical condition(s), allergies, or injuries we should know about?
Emergency Contact:
Full Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email Address*
example@example.com
Payment Options
I would like to*

Register for one session (6 classes). Registration fee is $90 for the full session ($15 per class).Attend by drop-in ($20 per class)Attend by drop-in but use a Pay-as-you-go punch card (to purchase a punch card, please select from the options below)
Pay-as-you-go Punch Card Options for Purchase:*

Five (5) classes at $18 per class = $90Ten (10) classes at $16 per class = $160Twenty (20) classes at $13 per class = $260
Terms and Conditions for Punch Cards: All punch cards must be stamped/paid in full prior to the beginning of each class. Immediate family members, residing at the same address, are permitted to share a Pay-as-you-go punch card.

Punch cards automatically expire after twelve months from date of first activation (Exception: In the event of local public health restrictions that result in classes being suspended or reduced, expiry dates will be extended accordingly).

No returns or refunds provided for lost, stolen, unused or expired punch cards.
Methods of payment accepted for Highland Hustle registration:

Cash onsite or e-transfer to nsohd@bell.net
Your registration is considered complete once you:
- submit your registration form
- submit or confirm payment
- complete the HH_Online Waiver and Release of Liability
All participants must complete the HH Onine Waiver and Release form at least one per calendar year, or upon return to Highland Hustle classes following a serious illness or injury.
Should be Empty:

Highland Hustle Class Registration Form

Health Information

Emergency Contact:

Payment Options