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A Little Jazz, A Little Funk, A Little Hip-Hop, A LOT OF FUN!!!

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         REGISTRATION FOR WINTER SESSION OF SHEILA'S FITNESS JAM!

Name:___________________________________

Address: _________________________________

 ________________________________________
City:_____________________________________

Zip:______________________________________

Phone: (H) _________________________________

            (W)_________________________________

E-mail: ____________________________________

Check (x) if this is a NEW Address_____

Class # ______  

I am____am not____ a new student of Sheila's FitnessJAM  

Amount enclosed  $____________________________

MC/Visa :   Acct #____________________________

                   Exp. date_______________

Signature:___________________________________                                                No refunds after classes start and $25 fee for checks returned for any reason 
Please Make Checks Payable to:    

 SheilasFitnessJAM                                                                                            378 Harris Hill Road                                                                                        Williamsville, NY 14221
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