Bellydance Class Registration for Mondays at Dance Fxbg with Amy "Kiyaana"
Please complete this form to sign up for Amy "Kiyaana" Limbrick's 7 pm or 8 pm class held on Monday nights at Dance Fxbg (Eagle Village on Rte 1). This registration will save a spot for you in the class (space is limited).

If the session becomes full, priority will be given to those who are signing up for the whole session (7 classes) over those that are dropping in occasionally. Because the Sept/Oct session classes will each learn a choreography, signing up for the whole session is recommended.

If you need to miss a class during the session, the videos provided via email each week will help you learn what you missed.

Payment can be made directly to Amy (cash/check) or via PayPal. Please note that refunds are not possible once the class session has started. If paying via PayPal, find buttons here http://www.kiyaana.com/pay-for-monday-classes

Class observations are not allowed. All present during the class are expected to participate, unless advance permission has been given (for example, if an enrolled student has temporary injury, s/he may observe.)

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Do you have any specific physical limitations? (If "yes," please describe.)
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Liability Disclaimer: Bellydance is a physical activity. I understand that it is my responsibility to consult with a physician prior to and regarding my participation in bellydancing and/or exercise classes. I represent that I am in good health and suffer from no physical impairment that would limit my participation. I understand that I am participating in bellydance at my own risk. I agree that Amy "Kiyaana" Limbrick is not liable for any personal injury that I may suffer during class or at any related function. I hereby agree to the above conditions. (Please type your name as your signature to affirm this.)
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