March Pilates 4-Week Session Registration

Pilates

Saturdays 8:30-9:30am, March 7th - March 28th, $65
Student Name*

First NameLast Name
Parent Name (if under 18)

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
Please tell us about any allergies, medical, or special circumstances we may need to know about.
Waiver of Liability:

By submitting this form, I acknowledge the risk in physical activity during dance, fitness, and movement classes and release Dirigo Conservatory of Movement from all liability of injury that may occur while participating in said risk.
$65 Payment is due at the prior to the first class. Payment can be made in the form of cash, check to Dirigo Consveratory of Movement, or Venmo @Morgan-Sanborn.
Should be Empty: