2^ND STREET STUDIO 

SUMMER SESSION REGISTRATION FORM

**June 22^ND – August 28^TH **

Date:______________________

Name:_______________________________________

Address:_________________________________________________________________

City/State/Zip:__________________________________________________________

Phone Number:___________________________

Email:___________________________

Emergency Phone Number:_________________________________

Doctor:______________________________________

Write your initials in front of the workout plan you are paying for:

_____ $40…Unlimited visits

_____ $25… Saturday only—no substitutions.

Paid by:  Check#____________ Cash __________

(If registering by mail-please do not send cash.)

Please bring your workout shoes.  No street shoes are allowed on workout floor.  For safety’s sake, do not bring children to any workout.