Registration Form

All participants must pre-register

Name:  Address:
City:  State:  Zip Code:   
Cell #:    Evening #:   
Email:

Session Day:    Time: 
Session Day:    Time: 
Session Day:    Time: 

                                                                                Subtotal: 
                                                Senior/Student 10% Discount: 
                                                    50% High School Discount:  

                                                                                     Total: 

Do you have any medical conditions your teacher should be aware of?  yes no.  If yes, please explain:

I, the undersigned, voluntarily register for yoga classes and will assume full responsibility for my health and well being
while participating in class.  I have read and agree to follow session policies.  

Signature:  Date: