| Name: | _____________________________________ |
| Address: | _____________________________________ |
| City/State/Zip: | _____________________________________ |
| Home Phone: | _____________________________________ |
| Cell or Work Phone: | _____________________________________ |
| Email Address: | _____________________________________ |
Classes you are signing up for:
| Class Name/Level | Day | Time | Fee |
| Class Fee Subtotal: | $ | ||
| More than 1 class/week? Subtract 20% of Class Fee Subtotal | |||
| Any coupons? | |||
| GRAND TOTAL: | $ | ||