Registration Form for the Feldenkrais Open Public Class at the North Hall

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Registration Form for the Feldenkrais Open Public Class at the North Hall

Course Timing: Thursday February 23 from 4pm to 530pm
Course Address: North Galiano Community Hall, 22790 Porlier Pass Rd, Galiano Island, BC V0N 1P0

Name (first and last) *

Your Email address ( for registration purposes) *

Phone Number

Liability Release: By registering and attending, you are agreeing to release Jamie van Dam and Feldenkrais Dharma from responsibility for any injuries that you may receive as a result of attending and or practicing the lessons/classes. Please note, as with any exercise or health-related program or activity, you should seek the advice of your physician or other qualified health professional before participating.
*

Yes, I agree and acknowledge this selection as my electronic signature

Required

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms