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Application Form for ZUMBA®（Dec, 2021)
Organizer：KAPPA64（Chieko Yanagida）
Contact number : 090-4012-1389 / E-mail :
kappa64yokosukazumba@gmail.com
Charge：￥800
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* Indicates required question
Please fill in all participants.
This is a form for having fun lessons with everyone who can cooperate with COVID19 infection control. if you are a friend of mine and would like to participate, please forward the URL and enter yourself.
Last name & First name
*
Your answer
Mobile phone number (fixed home phone is possible)
*
Your answer
E-mail
Your answer
You must cooperate with the temperature measurement before enter the lesson studio
*
Those with a body temperature of 37.5 degrees or higher not allowed to enter the lesson studio.
Yes, I agree. We (kids, my companions) will measure our body temperature before enter the lesson studio
Required
You must be wearing a mask during the lesson
*
We ask that you always wear a mask "except when hydration"
Yes, I agree. We (kids, my companions) will wear a mask in the lesson studio.
Required
No food or drink in the lesson studio
*
*You can drink for hydration when needed！
Yes, I agree. We (kids, my companions) don't eat or drink in the lesson studio.
Required
No photographs inside or outside the lesson studio
*
Please refrain from taking photos inside and outside the venue , including commemorative photos with friends to ensure social distance.
Yes, I agree. I will not take pictures & will keep distance
Required
Schedule of ZUMBA®️ (Please select the dates of participation)
*
Multiple answers allowed (only the dates that are currently are sufficient. Additional information can be added again.
1st,(Wed)19:40～ YOKOSUKA ARENA 3F・2nd,TAIIKU-SHITSU
2nd,(Thu)18:00～ YOKOSUKA SOUGO-FUKUSHI-KAIKAN 6F・TAIIKU-SHITSU
7th,(Tue)18:00～ Yokosuka Industrial Comunnity Plaza (Next Billding from YOKOSUKA ART THEATER)
9th,(Thu) 18:00～ YOKOSUKA SOUGO-FUKUSHI-KAIKAN 6F・TAIIKU-SHITSU
14th,(Tue) 19:00～ YOKOSUKA SOUGO-FUKUSHI-KAIKAN 6F・TAIIKU-SHITSU
15th,(Wed)19:40～ YOKOSUKA ARENA 3F・2nd,TAIIKU-SHITSU
16th,(Thu)18:00～ YOKOSUKA SOUGO-FUKUSHI-KAIKAN 6F・TAIIKU-SHITSU
21th,(Tue)19:00～ YOKOSUKA SOUGO-FUKUSHI-KAIKAN 6F・TAIIKU-SHITSU
23th,(Thu)18:00～ YOKOSUKA SOUGO-FUKUSHI-KAIKAN 6F・TAIIKU-SHITSU
Required
You must contact the organizer when a COVID19 infection is found
*
If the infected person is found, please cooperate in contacting and reporting to those who were present on the lesson day you attended the past.
Yes, I agree. I will E-mail to organizer(KAPPA64) if I infection COVID19 , The date of I visited the lesson studio.
Required
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