Early Fall 2010 Registration Form
Please check which class(es) you wish to attend:

Yoga Classes @ APT (5 weeks): 10/4/10 - 11/4/10
____ Mondays: 7:00-8:30pm - Continuing - $60

____ Wednesdays: 5:30-6:45pm - Beginning Gentle - $50

____ Thursdays: 8:30-9:45am - All Level - $50

Class @ Red Ridge Farms (5 weeks): 10/4/10 - 11/4/10
____ Wednesdays: 10:00-11:00am - All Level - $50

Class total: $_______

____ Enclosed is my non-refundable $25 deposit per each class. OR....
____ Full Payment enclosed
Make checks payable to S. Broderick

NAME:______________________________ PHONE #: ______________________

E-MAIL: _____________________________

TOTAL: ___________ COMMENTS _____________________________________