Enrollment Form

First Name*

Last Name*

Email*

Phone Number*

Session preference

Mon/wed at noon*

First Choice Second Choice Can’t do it

Tues/Thurs at 5 pm*

First Choice Second Choice Can’t do it

Declaration*

I understand that once the program begins, enrollment fee is non-refundable and that I will be asked to sign an informed consent and waiver form before participating in the first session.

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