SLAG at AOD Registration

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Let's get ready to Sweat Like A Girl! Please take a moment to fill out this registration form.

Once you submit your form - you will receive an email confirmation, along with a link to complete your waiver.

If you have any questions, call, text or email me.

I look forward to seeing you at class!

Heather Gidusko

610-207-4682

heather@heathergidusko.com

Email *

First and Last Name *

Phone *

Address *

Age *

Emergency Contact Name *

Emergency Contact Phone *

Have you had a physical exam by a medical doctor within the last 12 months?
*

Yes

Please state if you have current/previous health diseases/issues that I should be made aware of:
*

List any medications that I should be aware of in case of emergency.
*

What would you like to accomplish as a result of attending these classes?
*

I am registering for: *

Full 8 week session of unlimited classes - $135 **Best Value

I will be dropping in at the rate of $20 per class

I am starting late, but want unlimited at a prorated price - ask Heather for what is due

I will secure payment prior to attending class using this method: *

Venmo @Heather-Gidusko

Zelle 610-207-4682

Paypal

Cash - due in person at first class

Check - due in person at first class

How did you hear about me?

A copy of your responses will be emailed to the address you provided.

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