Class Registration Form 2022

Please fill out the following form to begin your registration.

Once we have processed your form, you will receive a link to set up your monthly tuition payment. You will also receive an email with helpful information about the class you have selected. If you are registering for yourself and someone else, please complete a form for each participating member. See you in class!

Name

First Name

Last Name

Email

Phone

(###)

###

####

Please indicate your Class Preference

Option One : One Class Per week ($72 billed monthly)

Option Two: Up to 3 Classes Per Week ($115 billed monthly)

If you selected Option One, please select your day and time

Due to the limited class size, your day and time cannot be changed without prior approval.

Sunday 8:30am-9:45am

Tuesday 6:15pm-7:30pm

Wednesday 8:30am-9:45am

If you selected Option Two, you are all set. Simply come to any or all of the classes offered during the week!

For students who are not currently patients of the clinic, please indicate any health, injury, or ability concerns not covered in your initial consultation.