Chair Dance Fitness for Elders Class Registration Form
Thank you for registering for Zaccho Dance Theatres Chair Dance Fitness Class at Bayview Opera House! Please fill out the form below to secure your participation.

Class takes place on Wednesdays at 10:30AM. Please see flyer or below for all dates.

For questions or concerns please contact:
Saharla Vetsch, YPAP Community Engagement Coordinator
saharla@zaccho.org
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Email *
Participant Name *
Participant Age *
Have you taken chair dance fitness classes before? *
Does the participant have any specific limitations, chronic illness, or medical conditions they would like the instructor to be aware of? If yes please describe. *
Class Dates (Please select any and all you will be attending) *
Required
How did you hear about this class? *
Emergency Contact *
Emergency Contact Phone Number *
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