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Pearls For Life Registration Form-Crown Jan 2021
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* Indicates required question
Name (First & Last)
*
Your answer
Child's Name (First & Last)
Your answer
Birthdate (Month, Day, Year)
Your answer
Email
*
Your answer
Address (House number, Street, City, Zip)
*
Your answer
Phone number (xxx)xxx-xxxx
*
Your answer
Emergency Contact Name, Relation and Phone Number
*
Your answer
Class you are registering for:
*
12:00-12:55 Wednesday Yoga Time for Kids (Crown Co-op)
Required
Experience
No Experience
Beginner (0-6months)
Intermediate (6mo-2years)
Advanced (3+years)
What type of exercise do you do?
Your answer
Any injuries? (if yes, please explain)
Your answer
Payment Information
Pricing: $50 deposit + $100 Fall Semester + $120 Spring Semester
Payment Options
Venmo》@Arianna-Caligiuri
Paypal》
pearls4life@gmail.com
Check to: Pearls For Life
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