Student Name *
Student Name
Parent Name (if applicable)
Parent Name (if applicable)
Phone *
Address *
Date of Birth (Student) *
Date of Birth (Student)
Phone Number
Payment Information
*Visa or Mastercard Only
Checkbox *
I have read the guest agreement on responsibility and liability printed below and agree to its contents. The terms & conditions of this agreement shall apply to the original terms and all renewals thereof. I have also read & accepted the cancellation policy.

All persons using the Club facilities do so at their own risk. The Club is not responsible for any personal property that is lost, stolen, or damaged on Club premises. The Club will not be responsible for any injuries sustained by members, guests, or automobiles. 


Cancellation policy: Classes must be canceled 24 hours in advance, in order to be able to do a make up. A make up must be scheduled within 24 hours of the missed class. Make up must be done within the month on a different day than original clinic.