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June 2023 Tai Chi/Qi Gong Registration
Please fill out a new form for each person attending class.
* Indicates required question
Full Name
*
Your answer
Email Address (No corporate or university emails please)
*
Your answer
Phone Number
*
Your answer
Select which classes you will attend this month.
*
June 14 (virtual)
June 24 (I will attend in-person.) - Mindfulness Meditation & Tai Chi
June 24 (I will attend virtually.) - Mindfulness Meditation & Tai Chi
Other:
Required
Have you read and do you agree to the required Informed Consent form below? (Choosing "Yes" is considered an e-signature for the Informed Consent shown below.)
*
Yes
No
Are you a university/college student?
*
Yes
No
If you answered yes to the above question, please indicate your school's name, program you are enrolled in, and expected graduation date.
Your answer
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