Mandala Registration (Hurst)
This form is only to be used for all of Mandala services in Hurst. Address - 744 E. Pipeline Rd. Hurst, Tx 76053

Dance-
Fees for adults - 1st month $85 (tshirt, registration & fee), 2nd month- $50
Fees for kids - 1st month $120 (tshirt, registration and fee) 2nd month $85 ( 1 & half hour)
Fees for kids- $100 for the 1st month & $65 from the second (An hour class)

Tutoring - $15 materials & $60 monthly/subject or $100 combo

Public Speaking - 10 sessions $75. Money back guaranteed if not satisfied

Yoga - $10
Zumba - $5/ class ( AN hour long!)
Email address *
Your answer
Name of the student *
Your answer
Age (required for under 18)
Your answer
Parent's name (required for under 18)
Your answer
Contact phone number *
Your answer
T shirt size *
Your answer
Nepali & Bollywood dance schedule
Zumba
Ballet & Jazz
Hip Hop
YOGA
Tutoring
Policies - A) I hereby release The Mandala and its agents from any claims, demands, and causes of action as a result of my voluntary participation and enrollment, and I agree to assume full responsibility for any risks, injuries or damages-known or unknown- which may occur as a result of participating in the program. B) MEDIA USE: Photos/videos may be taken of the classes and I agree to give The Mandala the permission to use the photos/videos for their promotional purposes. I will let the The Mandala staff know in person if I do not want any pictures to be taken. C) I, my heirs or legal representatives forever release, waive discharge and covenant not to sue The Mandala, its owner, agents, instructors or staff for any injury or death caused by my or my child's participation in any of the Mandala classes. D) All kids must wear there "The Mandala" shirt while attending their classes. E)The payment needs to be made before the month starts. There may be penalty for late fees.** F)Make up classes may be available upon prior notice. By submitting this form, you agree with the studio policies. *
Any allergies or medical conditions that we should know about? If YES (Please also let the teacher know in person if any special attention is needed). *
Your answer
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