EmailMe Form - Intro To Tai-Chi Summer 2016

Name *

First Last

Home Phone

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Email *

Mobile Phone

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Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Class Fee

This 10-week class is $30. Cash or a check is due the first day of class. Checks should be made directly to Bob Yu.

How did you hear about this class? *

Informed Consent and Hold Harmless/Release Agreement:
I understand that participation in exercise activities involves a certain degree of risk. I have carefully considered the risk involved and I understand that participation in these activities is entirely voluntary. By printing my name below, I release the Wil-‐Mar Neighborhood Center and Bob Yu from any and all claims of liability arising out of my participation in this class. Photos may be taken during a session and I allow these to be used for educational and marketing purposes. *

I have read and agree to the above statement.

Any comments or questions?