FALL/HOLIDAY SESSION FIT OVER FIFTY
YOU ARE REGISTERING FOR FIT OVER FIFTY Fall/Holiday Session, this session runs through the New Year. 10/9-1/3.
PLEASE NOTE: Our Monday morning class is a bit more challenging, however chairs are still provided (if needed) and modifications are always given. Be advised that floor work is included in this class format. This class is not pro-rated, but one make-up session is provided. I am sorry for any inconvenience.
Cash or check made payable to Michelle Kellett is due on the first day of the session. Thank you!
NEW CLASS PARTICIPANTS: Please fill in all fields. Thank you!
I am registering for:
Tuesday/Thursday mornings; 9-9:50am. Cost of this session is $149.50 (23 classes) 10/9, 10/11, 10/16, 10/18, 10/23, 10/25, 10/30, 11/1, 11/6, 11/8, 11/13, 11/15, 11/20, 11/27,.11/29, 12/4, 12/6, 12/11, 12/13, 12/18, 12/20, 12/27, 1/3.
Mondays only; 9-10 am. Cost of this session is: $90.00 (9 classes + 1 bonus or make-up day) 10/15, 10/22, 10/29, 11/5, 11/12, 11/19, 11/26, 12/3, 12/10. MAKE-UP CLASS IS 12/17. * please note: the Monday class is now an hour in length and the cost per class has changed.
Monday/Tuesday and Thursdays. Cost of this session: $239.00. ( 33 classes in total). See all dates above.
Your date of birth:
Best number to reach you:
Emergency contact name:
Emergency contact number:
If there are dates that you know you will be missing, UPON REGISTRATION, you may include those dates below and I will send you a pro-rated total for the class. NOTE: Mondays class will not be pro-rated.
and just a few words to describe your fitness level,...
How did you hear about Fit over Fifty?
Please take a moment to read this waiver, it must be signed and submitted prior to participation: I have agreed to participate in the Fit over Fifty fitness program with Michelle Kellett, being held at the Sodus Point, NY Community Center. I recognize that the program involves physical activity including, but not limited to, strength training, balance challenges, cardiovascular activities and flexibility training. I hereby affirm that I am in good physical condition and do not suffer from any known disability or condition which would prevent or limit my participation in this exercise program. I will notify Michelle Kellett of any such issues, in writing, prior to participation and will submit a medical release form prior to participating, if necessary. I acknowledge that my registration and subsequent participation in Fit over Fifty is voluntary. In consideration of my participation in this program, I hereby release and discharge Michelle Kellett from any claims, demands and causes of action as a result of my voluntary participation and registration in this class. I hereby waive and release all rights to photography and video taken by or for Michelle Kellett during the program. Any photos or videos taken by or for Michelle Kellett are sole property of Michelle Kellett and can be used in any advertisements, marketing or publications used to promote any program offered by Michelle Kellett. Registration is required prior to participation. Payment is due at time of registration. If you request a refund in writing within 24 hours of your registration, you will be entitled to a full refund, ( less 15% administration fees, if applicable). After the 24 hour grace period, all fees are non-refundable, and non-transferable. By checking the box below, you agree to all terms listed in this agreement. _______________________________________________
Yes, I agree.
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