Physiotherapy Posture & Pilates

Balance in Life
Home      Enrolment Form
Print this pageAdd to Favorite
Please make sure you fill in the ** (required information) spaces or the form will not send. Thank you for your interest.

 
First name**:
Last name**:
Street (or mailing address)**:
City**:
Postcode**:
Phone**:
Mobile phone to text class changes:
Title of class enrolling**:
Day & Time of Class enrolling**:
Use if enrolling in 2nd Class name day & time:
email for updates or changes to term classes**:
Payment method (chq/cash/direct deposit):
Comments or questions about enrolment:
 
(** Required Fields)
If you prefer you can print this form and send it to the studio with cheque or drop off with cash payments. Please note there are no online credit payments but direct deposit payment option is available. Details of these if needed, will be sent to you once enrolment form has been received.
Please note payment for the Term classes must be made by the start of the first lesson. If you are only paying for one lesson at a time then the casual rate will be charged.
Thanks