Tai Chi Chuan Class Mail In Registration

Name:______________________________________Phone: ________________Date: _______

Address: ______________________________________________

City: ___________________________________ State: _____ Zip: __________

E-mail:______________________________

Class: Beginners:     Scheduled starting Date: Tuesday June 3, 2025

6:30 - 7:30 pm

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:___________