Program Registration Form- Summertime Family Zumba

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Thanks for your interest in our "Summertime Family Zumba" program, which will be held every other Tuesday (July 19, Aug 2, Aug 16, Aug 30) from 10:30am-11:30am

This class is open to anyone over age 5. Children must be accompanied by a parent or guardian.

Please fill out all the required fields below. We will do our best to contact you if the event is canceled or rescheduled.

Please also note- ALL REGISTERED FAMILIES WILL BE REQUIRED TO COMPLETE AN INSPIRA WAIVER FORM BEFORE PARTICIPATING IN THIS PROGRAM.

Your First Name *

Your Last Name *

Your Phone Number *

Please enter your full 10-digit phone number, no dashes or spaces.

Your Email Address (optional)

Your City / Municipality *

Please select the community closest to yours if you reside in an unincorporated area. Thank You!

Bridgeton

Commercial

Deerfield

Downe

Fairfield

Greenwich

Hopewell

Lawrence

Maurice River

Millville

Shiloh

Stow Creek

Upper Deerfield

Vineland

I prefer not to say.

Other:

How did you hear about the program? *

Will there be anyone else attending with you? *

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