Imagination Place - Center for Music and Movement

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AntiGravity® Yoga

Music Together®

Imagination Workshop™

Below is a form you can fill out to register for all classes.

**Please be sure to select your tab for your preferred session!**

Music Together: You will need to register infants separately as siblings. There will be no charge for infant siblings as long as he/she is 8 months or under and accompanying a registered sibling.

Your First Name:*
Your Last Name:*
Street Address (including apt. number):*
City:*
State/Province:*
Zip/Postal Code:*
Home Phone:*
Work Phone:
Mobile Phone:
Email:*	Contact Preference:

Registrants

First Name

Last Name

Date of Birth (mm/dd/yyyy)

Registrant #1

Registrant #2

Registrant #3

Class 1^st Choice

Location:	Class Type:

Class:*
<Select Location and Class Type first>

Class 2^nd Choice — Please select a second class in case your first choice is unavailable. If your first choice is full, then you must select an open class for your second choice in order to pay for and confirm your spot in the second class.

Location:	Class Type:

Class:
<Select Location and Class Type first>

* - required fields.

Registrants

Class 1st Choice

Class 2nd Choice — Please select a second class in case your first choice is unavailable. If your first choice is full, then you must select an open class for your second choice in order to pay for and confirm your spot in the second class.

Class 1^st Choice

Class 2^nd Choice — Please select a second class in case your first choice is unavailable. If your first choice is full, then you must select an open class for your second choice in order to pay for and confirm your spot in the second class.