Name *

First Name

Last Name

Phone *

(###)

###

####

Medical Health - All personal information will remain private *

Do you have any pre-existing conditions that may impact your participation in this class, workshop or session?

Yes

No

Emergency Contact Name *

First Name

Last Name

Emergency Contact Phone # *

(###)

###

####

Acknowledgement of Payment and Refund Policy *

A Deposit or Full Payment is necessary to register and hold your spot in any class, workshop or private session. I understand and agree that my deposit is non-refundable/non-transferable and the full balance of class fees are due at the registration event/first day of class (or other agreed upon payment schedule) or I forfeit my spot in the class. Exceptions will be made for classes cancelled by Rosie Bitts. Special exceptions may be made at our discretion only. Payment for class is non-refundable after the class start date but you may be able to transfer your spot to another class time due to illness or injury. Please note for Private Sessions: 24 hours notice is needed for a cancellation or you may lose your session fee. You may only cancel and rebook your prepaid private session once (except for extenuating circumstances). Sessions must be used within a 6 month time period.

I understand and agree.