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Tantra
Registration Form
TO REGISTER,
Print, complete and mail this form to TantricHearts.com, 104 Denton
Drive, Seabrook, TX. Please make checks payable to Kim Walker and
enclose full tuition or a $50 non refundable deposit* with your
application to reserve your class space. If a deposit only is enclosed,
the balance is due the first class. The class is limited and applications
will be accepted on a first come basis.
NAME____________________________________________________________
ADDRESS________________________________________________________
CITY____________________________STATE______________ZIP___________
HOME PHONE__________________________WORK_____________________
Class choice:________________________Day____________Time____________
Known physical
limitations_____________________________________________
I hereby stipulate
that I am physically sound to proceed with instruction in Yoga.
It is Further agreed all exercises and lessons shall be undertaken
at my sole risk and that TantricHearts.com shall not be liable for
injuries or damages to my person or property arising out of, or
connected with, the use of services or facilities of TantricHearts.com
or the premises in which the same are located. I hereby forever
release and discharge TantricHearts.com from all such causes of
action.
*deposits will
be refunded if scheduled class does not make.
Amount Enclosed______Signature_________________________Date____________
You
may register by email at info@TantricHearts.com
visit us
at www.TantricHearts.com
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