That Pilates Girl, LLC

Registration Form

2012

Last Name__________________________  First Name_________________________

Email______________________________   Date______________________________

Phone (day)_________________________ (evening)__________________________

(cell)______________________________  

Address_______________________________________________________________

City, State Zip __________________________________________________________

List your class selection below:

Class Type (Mat/Reformer) ____________

Day and Time _______________________

Mat Class:

            ______ $240 (two classes per week for 8 week session, $15/class)         $______

            ______ $144 (one class per week for 8 week session, $18/class)             $______ 
            ______ $20/class (drop-in)                                                                         $______

Private Reformer Session:

            ______ $560 (two classes per week for 8 week session, $35/session)     $______

            ______ $320 (one class per week for 8 week session, $40/session)         $______ 
            ______ $45/session (drop-in)                                                                     $______

Duet Reformer Session:

            ______$400(two classes per week for 8 week session $25/session)        $_______

            ______$240(one class per week for 8 week session,$30/session)            $_______

            ______$35/session (drop-in)

Total Amount Due: (check payable to That Pilates Girl, LLC)                                   $______

How did you hear about me:__________________________________________________