Wasatch HEMA beginners class registration
To help us know who is planning on attending the beginners class please register below. Payment will be handled in class as well as signing a code of conduct.
Which Class are you registering for?
Name
Your answer
Address
Your answer
Date of birth
MM
/
DD
/
YYYY
Phone Number
Your answer
Email Address
Your answer
Emergency Contact person
Your answer
Emergency Contact person's phone number
Your answer
Emergency Contact's relationship to you
Your answer
Do you have any medical conditions you feel we should be aware of? (Asthma, Heart Conditions, Diabetes, Food or medication allergies, EpiPen, Inhailers, Insulin, Glucose, ETC)
Your answer
Where did you hear about us?
Your answer
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