Please complete the following information NO LESS THAN 3 WEEKS PRIOR TO THE COURSE DATE:

Studio Owner's Name:
Employee's Name: Home#:
Email: Cell#:
Street Address:
City:  State:
Zip: Apprentice Applicant: YES  NO
Course Title: Dates:
Course Location:  
Please confirm: Attendee is non-paying staff YES  NO OR Attendee is paying YES  NO
I have faxed in the employee's non-compete to 212.997.7356   YES  NO

Please charge the following card the Course Manual Fee of $30.

Method of payment: Mastercard   Visa   American Express  Discover

Credit card # Expiration date:

 


Course Policy: Any course may be cancelled if attendance is less than 3 pariticpants. If you have not registered 3 weeks prior to course dates please call us to make sure the course will be held.

I accept these terms of registration.
SIGNATURE: _________________________________________________

Call us with questions 800-IMX-1336. We look forward to helping you grow your business!

NOTE: Most courses have prerequisites. Please check to make sure your employee is eligible for the course you are registering him for.

Thank you!

IM=X Pilates Studios