Event Registration

To register for any upcoming event, please complete the following and mail to me your full registration fee (or deposit), or pay online using the PayPal payment system (after you submit this form you will get to the paypal button).

Event Name:

Event Date:

Name

Name :: ex. Jean Doe

Mailing Address

City

State

Zip Code

Phone

Email

How did you hear about this event?

Have you practiced yoga before?

Any injuries, conditions, or allergies I should know about?

Payment:

Please review specific event details for total fee, deposit, and payment due dates. I accept checks, cash and you may pay online using paypal. Please fill out the details below that apply to you. If you want to pay by credit card, please click the paypal button that will appear after submitting this form info. PLEASE NOTE that there will be a service fee of $14 on all credit card payments. If you are paying by check please fill out all of the fields below and you will receive mailing instructions:

For additional information please contact Jessica at 719 209 2108

How are you paying:

Cash
Check
Online Credit Card

Registration Fee/Deposit:

If paying a deposit please indicate amount here?

If paying a deposit please indicate amount here? :: Need only fill this out if applicable

Amount owed after today's deposit:

Amount owed after today's deposit: :: Need only fill out if applicable

Leave any special instructions or messages here:

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Anti-spam image :: Please write the letters and numbers you see.

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Event Registration

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