Registration for classes

for Journey to Wellness class; $20 for 1 session
($18 if paid on-line)

We protect your privacy. Personal information will not be sold or shared with any other organization. If you do not wish to be on our mailing list, check here:

* required

*Class date: (MM/DD/YY)

*First name:

*Last name:

*E-mail address:

*Address:

*City

*Zip

*Phone/home: (xxx-xxx-xxxx)

Phone/work: (optional)

Registering only; will pay $20 at first class.
Payment: On-line by credit card (a secure transaction) $18

(Click on Send to complete the registration process)

Class code: (for office use only)