Name *

First Name

Last Name

Phone

(###)

###

####

Please select the following group programs you'd like to register for: *

All programs are four sessions (60 minutes in duration) in consecutive weeks $250 plus tax per program per participant. Start Date:

Foundations (Series 2): Tuesday August 6th 5:30-6:30pm

Breaking 100 (Series 3): Thursday August 8th 5:30-6:30pm