Registration for Free Bellydance Class at Dance Fxbg with Amy "Kiyaana" on Aug 12

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Please complete this form to sign up for Amy "Kiyaana" Limbrick's 8-8:45 pm class on Monday, Aug 12 at Dance Fxbg (Eagle Village on Rte 1). This registration will save a spot for you in the class (space is limited).

If the session becomes full, a waitlist will be available.

These classes are group classes. The minimum number of students is 4, the maximum is 18.

There is no child care available at Dance Fxbg.

Class observations are not allowed. All present during the class are expected to participate, unless advance permission has been given (for example, if an enrolled student has temporary injury, s/he may observe.)

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7 pm Continuing Bellydance (Intermediate/Advanced) on Mondays at Dance Fxbg

8 pm Intro & Essentials (Beginner/Adv Beginner) on Mondays at Dance Fxbg

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Do you have any specific physical limitations? (If "yes," please describe.)

Liability Disclaimer: Bellydance is a physical activity. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in bellydancing and/or exercise classes. I represent that I am in good health and suffer from no physical impairment that would limit my participation. I understand that I am participating in bellydance at my own risk. I agree that Amy "Kiyaana" Limbrick is not liable for any personal injury that I may suffer during class or at any related function. I hereby agree to the above conditions. (Please type your name as your signature to affirm this.)

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