Sign up for a Watsu Class 
Sign in to Google to save your progress. Learn more
Email *
Class Code *
Please refer to the class page to find the class code.
Attendance *
if you taking the class for the first time, select "regular".  If you are auditing the class which you have taken within 3 years, select "audit" and you will get 40% discount on the tuition as long as the class is not filled with regular students.
Name *
Name AKA
Sex *
Date of Birth *
MM
/
DD
/
YYYY
Zip Code *
Address *
Phone *
How can we contact you on Day 1?
Tell us your contact ID on WhatsApp, Line or Messanger so that we can contact you in case we need to before meeting on Day 1.
WhatsApp
Contact Toru at:  +81 9098565386
Line
Contact Toru at:  totos_jas
Messanger
Contact Toru at:  dolphinflow
Emergency Contact *
Please give us the name and the phone number in case of emergency during the class.
Lodging and Food *
There is no hotel in the village.  Rooms are limited.  We take your request for single or double occupancy into account but it depends on the vacancy and other students.  We will contact you about the availability for your confirmation.
Pick-up *
Do you wish to be picked up at Ginoza IC on Day 1?
Inquiry
Please feel free to ask any questions and requests if you have any.
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy