1. Workout Warrior Registration
AFLCA Certified Instructor: Loretta King
(790)490-0311 or (780)965-4028
workoutwarriorwomen@gmail.com
Registration:
Name: _____________________
Phone: ________________________
Email: ___________________________
Emergency Contact:__________________________
Birthday: ________________________________
What are your expectations of the group?
____________________________________________________________
____________________________________________________________
____________________________________________________________
_________________________________________________________
Would you like to register for:
10 classes for $60 _____ Monday or Thursday ___ Babysitting? ____
Both Monday and Thursday $120_____
Drop in $8 per class _____
Risk of Injury to Participants: I understand that participation in any physical activity
involves inherent risk and that even when safety precautions are utilized, injuries can
occur. I also understand that if I experience unusual pain or physical discomfort during
participation in any activity, I will decrease or stop exercising and inform the instructor of
my symptoms. I am aware that personal health/accident insurance is my responsibility. I
claim that to the best of my knowledge, I do not have any medical/physical disability that
will preclude my safe participation in this program.
Signature ______________________________________
Date_____________________________
(signature required to validate registration)