Yoga Registration Form

YOGA CLUB SUBSCRIPTION

Please complete this form to place your advertisement to our website
REGISTRATION
FULL NAME

First NameLast Name
GENDER

FEMALEMALEOther or prefer not to say
ADDRESS*

Street Address

Street Address Line 2

Town / CityCounty / State

Postal / Zip CodeCountry
E-MAIL*
PHONE NUMBER*

Area CodePhone Number
Date of class you will attend:

MonthDayYear
Date
Rates and Payment

Get a discount for online registration and a bigger discount for paying online!

Regular drop in-fee is $12.00

Reserve online fee (but paying in person): $11.00

Pay ahead online is $10.00 (nonrefundable)

Five sessions for $50 (must be used within a year of purchase).
Payment Options
prevnext( X )
Pay later ($11.00 due at class)$ Free

Pay online now (non-refundable)$10.00

5 Sessions (to be used within year of purchase)$50.00

Sign-up only - I have prepaid$ Free

Total $0.00
The payment is ready! It will be completed once you submit the form.
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YOGA CLUB SUBSCRIPTION