Move Better. Feel Better. Sign-Up Form!
Exercise for Strength, Balance, and Everyday Life led by a physical therapist!
Participant Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Select Dates for which you would like to attend (all Wednesday 11-11:45 am)
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September 16
September 23
September 30
October 7
October 14
October 21
October 28
November 4
November 11
November 18
November 25
Other
Additional Comments or Questions (you can note if you have pain or any limitations here that the teacher should know about)
I understand that physical activity carries a risk of injury, and that Dance Innovations, Inc., its staff, instructors, landlords and lessors are not responsible for injury to me arising from participation in classes or related events, nor for lost property. By typed signature, I confirm that the information on this form is accurate and that I understand the above stated risks. I give permission to appear in Dance Innovations social media and website posts intended for information purposes regarding this class; no names or personal information will be shared without specific permission.
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By submitting this form, you have confirmed attendance to the classes listed. All classes are located in the Dance Innovations, Inc. building at 3 Townsquare, Chatham, NJ. When arriving in the lobby, please look to make payment. Classes are $26 for a single class or $100 for a 4 pack bought together. We accept cash or check only.
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