NEW CLIENT SPECIAL!

Complete Intake Form to receive 4 classes at 40% OFF!

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Birth Date

Parent Approval required if under 18

YYYY

Parent or Guardian Name

(if client is under 18 years of age)

Parent or Guardian Phone Number

(###)

###

####

Emergency Contact Name

Emergency Contact Phone Number

(###)

###

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Studio Policies

I have read and agree to abide by the Studio Policies

I have read and agree to the Participant Release Form

How did you hear about us? If applicable, who can we thank for referring you?

Please take a 50% off your first purchase of 4 Classes, that’s 4 classes for $59!

Select the 4 Class Package and use the code

at checkout

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