APPLICATION FORM
To participate in one of our classes, printout and send the completed form and payment to:
CCBodyMechanics
37 Althorp St, East Gosford.
2250
______________________________________________________________________
Name of Participant:_________________________________________
Address:__________________________________________________
_________________________________________________________
Phone:___________________
Email:__________________________
Occupation:________________________________________________
Age:_____________________ Sex:__________________________
Which
Class you are interested in:Class____________________
Day:____________________
What would you like to get out of these classes?
I am sending $20 to secure my place ____
(Full payment
to be made at the first class.)
I am sending full payment of $130 ______
(Please make any cheques payable to Tim Barrett)
I agree to
take full responsibility for myself during the classes
Signed: __________________________________________
Central Coast | Body Mechanics
EXCELLENCE IN MASSAGE AND ALL SOFT TISSUE THERAPY
Located in East Gosford - the heart of the Central Coast