Stretch & Sweat Registration & Waiver Form
Please fill out your details, select your payment option, and agree to the liability waiver to join the class.
Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
How will you pay?
*
Drop-In $10 per class
Founding Member $40 per month
4-Class Punch Card $36
Cash at the door
Send payment to: Venmo @Jennifer-Howell-109 or Cash App $dancewithjennifer or bring cash to class.
I voluntarily choose to participate in Stretch & Sweat led by Jennifer Miller Howell at Jennifer’s School of Dance in South Mississippi. I understand physical activity involves risk of injury and I assume all risks. I have consulted or will consult a physician if I have medical conditions affecting my ability to exercise. I will inform the instructor of any injuries or limitations before class. I release Jennifer Miller Howell, Jennifer’s School of Dance, and WinWithJen from any claims or liability arising from my participation.
I have read and agree to the liability waiver above.
*
I have read and agree to the liability waiver above.
Submit Registration
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