Tai Chi Class Mail In Registration

Name:______________________________________Phone: ________________Date: _______

Address: ______________________________________________

City: ___________________________________ State: _____ Zip: __________

E-mail:______________________________

Class: Beginners:     Scheduled starting Date: Tuesday November 3rd, 2026

Time: 6:30 - 7:30 pm ... The class for November 17 will be held on Thursday November 19.

Class will be canceled if minimum enrollment not achieved. No refunds after the first class.

8 classes ---$80.00 or $15.00 per class. Amount Enclosed:___________