Your Email (required)
Mobile Phone Number
Can we text you?
Requested Dates of Service
Date of Birth (Month, Day only)
How Were You Referred? (Select One)
If you selected "Friend", please indicate name.
Have you practiced yoga before?
If yes, when?
Payment is required prior to your scheduled classes. Once you complete the form, please go to the corresponding payment option below the form and send payment.
Please indicate your payment method. (Select One)
Please Note: If you use PayPal, there is a $5 processing charge to cover the cost when registering.
Please enter the amount to be paid.
Please enter any discount code you may have.
Waiver Statement: I do not have any physical conditions or disability that would limit my participation or preclude an exercise program. The instructors shall not be held liable for any injury, loss or damage to property and/or persons sustained during or as a result of participation in this class.
By typing your name, you agree to the waiver statement above.