Registration Form for Lake Center Yoga

First Name:                                                        Please list how much you paid and how: cash ____

Last Name:                                                                                                                        check  ____
                                                                                                  
Address:                                                                                                   credit card on website ____                                 Street

           City

           State, Zip

Email ID: (please print clearly)

Daytime  Phone:

Cell Phone:

In case of emergency please contact: Name and phone number.

If you have practiced yoga how long and what style.
 

How did you hear about Lake Center:
 

Please List Health Concerns

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I realize that all classes I have paid for have to be completed during the current 6 week session no
classes are transferable to another 6 weeks. I also realize  Lake Center Yoga and their instructors are
not responsible for any injuries.

Please Sign:

Signiture:______________________________________Date:___________________

                 We look forward to serving you to the best of our abilities. NAMASTE