Xtreme Hip Hop Step Registration

This form is to register for Xtreme Hip Hop Step session.
Name

First NameLast Name
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Are you familiar with Xtreme Hip-Hop Step?
Are you a Beginner, Intermediate, or Advanced?
What style of music you like most (Hip-Hop, R&B, Pop, Rock, Country, Latin, Reggae, Gospel, other)?
Session

1:1 Session - Are you someone who has never taken a step aerobics class, or have you taken a class but not Xtreme Hip Hop w/ SheritaJ? Are you someone interested in the class but not yet comfortable attending classes with a group of people? Are you someone who has taken classes but need a one-on-one to catch up to speed, or to perfect the craft? If any of the above is yes, then this is just right for you! These sessions are private - 1:1, and the sessions location are TBD (60 minutes). Please come prepared to learn the basics or any advance movements/combinations you'd like to try.
How did you submit your payment? (Sessions aren't guaranteed until your payment is received. Please note, the payment is non-refundable & non-transferrable.)
What is Xtreme Hip Hop?

Xtreme Hip Hop Step is a high-energy fitness class that fuses step aerobics with hip hop music and dance. This workout provides a fun, full-body cardio experience with dynamic routines set to old and new school tracks.
What to expect?

One-on-one sessions starts on time. Please try to arrive 5-10 mins early to give yourself time to find parking and get your spot on the boards. Wear active wear you can move in (no jeans) & comfortable sneakers. I highly recommend a cross training sneaker.
ADDRESS:

TBD
Waiver and Covenant Not to Sue

I have volunteered to participate in a program of physical exercise under the direction of Sherita Coardes - Certified Xtreme Hip Hop Step Coach, which will include, but may not be limited to, cardio and/or step aerobics. In consideration of any and all coaches agreement to instruct, assist, train and exercise with me, I do here and forever release and discharge and hereby hold harmless any and all other Xtreme Hip Hop Coaches, and all respective heirs, agents, contractors, assigns and employees for any and all claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected with my participation in this or any exercise program including injuries resulting there-from.

Assumption of Risk

I recognize the exercise might be difficult and strenuous and that there could be danger inherent in exercise for some individuals. I acknowledge that the possibility of certain unusual physical changes during exercise does exist. These changes include abnormal blood pressure, fainting, irregularities in heartbeat, heart attack, and in rare instances, death.

I understand that as a result of my participation in an exercise program, I could suffer an injury or physical disorder that could result in becoming partially or totally disabled and incapable of performing any gainful employment or having a normal social life. I recognize that prior to involvement in any exercise program, participants should obtain an examination by a physician. If I have chosen not to obtain a physician’s permission prior to beginning the exercise program with any and all other Xtreme Hip Hop Coaches, I hereby agree that I am doing so at my own risk.

I acknowledge and agree that no warranties or representations have been made to me regarding the results I will achieve from this program. I understand that results are individual and may vary.
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What is Xtreme Hip Hop?

What to expect?

ADDRESS: