Sunday Wellness Sign-Up Form
Join us for Sunday Sunrise Wellness featuring Tai Chi and Zumba under the Liberty Tree at Balfour Park. Sundays, July 26 – October 4, 2026, 4:00 PM – 5:00 PM, Liberty Tree, Balfour Park, 105 N Balfour Rd, Spokane, WA 99206. This free community wellness program is open to all ages and fitness levels. Please complete the registration form below.
Participant Information
First Name
*
Last Name
*
Date of Birth
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Month
-
Day
Year
Date
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
City
Emergency Contact
Emergency Contact Name
*
First Name
Middle Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Relationship to Participant
Program Selection
Which activity are you interested in?
*
Tai Chi
Zumba
Both Tai Chi and Zumba
Are you a returning participant?
Yes
No
Health & Safety
Do you have any medical conditions or physical limitations we should be aware of?
*
Yes
No
If yes, please explain
In case of emergency, I authorize program staff to seek medical attention on my behalf if I cannot be reached.
*
Yes
No
Signature
Electronic Signature
*
Date
*
-
Month
-
Day
Year
Date
Submit Registration
Submit Registration
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