Group Fitness Program Registration Group Fitness Program Registration Form "*" indicates required fields Location*Select an option...Jefferson ValleyBriarcliffI'm a...* Club Fit Member Non-Member If you are a Non-Member, please click here to fill out a Program Billing Form FIRST, in order to attend and be charged for a paid class. Jefferson Valley Programs*Select an optionKids YogaZumba KidsDance Jam with Liz MallonChen Tai ChiWomen’s Self Defense ProgramBriarcliff Programs*Select an optionApril Dance JamHIP-FIT ProgramKids YogaMother-Daughter YogaStrike Kickboxing ProgramsAutism Awareness Month ZumbaSpring Women's Wellness RetreatIntro to BalletStrike Kickboxing Programs*Select an optionKickboxingKnockout 30Mental Health Awareness Month Strike SpecialChen Tai Chi* Members: $80 Non-Members: $100 Saturday’s 1PM-2PM in Studio 2 | 4 week session | Starting April 26th (Class will meet 4/26, 5/3, 5/10, 5/17)Women’s Self Defense Program* Members: $90 Non-Members: $110 Wednesday’s from 7:00pm-8:00pm in Studio 1 | 3 week session | Starting May 14th (Class will meet 5/14, 5/21, 5/28)Spring Women's Wellness Retreat* Members: $40 Non-Members: $45 Sunday, May 18th | 3:00PM | Studio 1Autism Awareness Month Zumba* Minimum Donation: $25 Saturday, April 26th | 12:30PM | Studio 2Mother-Daughter Yoga* Members: $35 Non-Members: $40 Sunday, May 4th | 3:00PM | Studio 1Dance Jam with Liz Mallon* April 24th 11:35AM - 12:35PM | Studio 1Dance Jam with Liz Mallon* Members: $20 Non-Members: $25 Intro to Ballet* April 19th June 7th 1:30pm-2:30pm | Studio 1Intro to Ballet Pricing* Members: $25 per class Non-Members: $30 per class Mental Health Awareness Month Strike Special* Tuesday, May 13th with Jackie @ 10:00am Thursday, May 15th with Erica @ 6:30pm FREE to Members & Non-Members! HIP-FIT Program* Member: $25 Non-Member: $30 Program starts Friday, March 14th at 6:30pm in Studio 1 and will run every following FridayKickboxing Days and Times* Sunday: 9:00 am Sunday: 11:30 am Monday: 10:00 am Monday: 7:00 pm Tuesday: 12:00 pm Tuesday: 6:00 pm Wednesday: 10:00 am Wednesday: 5:30 pm Friday: 8:30 am Saturday: 9:00 am Saturday: 11:00 am You do not need to sign up for specific classes. Pick and choose whichever day you want and apply the pack to any class for flexibility. Registration must be at least 24 hours in advance.Membership Status* Member Non-Member Member Kickboxing Pricing* 1 Class/$25 4 Class Pack/$100 10 Class Pack/$225 20 Class Pack/$425 Non-Member Kickboxing Pricing* 1 Class/$35 4 Class Pack/$140 10 Class Pack/$325 20 Class Pack/$625 Knockout 30 Days and Times* Sunday: 10:30 am Monday: 11:15 am Wednesday: 11:15 am Friday: 11:15 am Knockout 30 with Patrick Consing Pricing* Member: $15 Non-Member: $20 Zumba Kids* Member: FREE Non-Member $90 (Session Pricing) Kids Yoga Pricing* Member: FREE Non-Member $125 (Session Pricing) Kids Yoga Pricing* Member: FREE PAYMENT:* Free Program Member House Charge eCash Credit Card Gift Card Participants Name* First Last Date of Birth MM slash DD slash YYYY Child's Name*Child's Date of Birth* MM slash DD slash YYYY Street Address*City*State*AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificZIP / Postal Code*This field is hidden when viewing the formAddress Street Address City State / Province / Region ZIP / Postal Code Primary PhoneEmail Address* Emergency ContactPhone NumberConsent*I represent that I/my child am/is in good physical condition and have no condition preventing me/us from safely participating in the Club’s fitness, sport, and wellness programs. To the extent that my/their physical condition changes over time, I understand that it is our responsibility to monitor my/my child’s physical condition and the Club will not be responsible for any changes in my/their physical circumstances. I/my child appreciate the risks associated with physical activity and the potential for physical stress, strain and injury. I/we also appreciate that there is risk to using or storing personal property at the Club. Accordingly, I/we assume knowingly whatever risks may be involved by reason of my/our use of Club Fit and its facilities, equipment and services. Further, I/we hereby agree to release, indemnify and hold harmless Club Fit, its members, principals, directors, officers, shareholders, employees, affiliates, agents, servants and representatives (the “Indemnitees”) from and against any and all action, claim or suit for personal injury, death or loss, liability or damage to property, costs, expenses or liability, including reasonable attorneys’ fees (collectively referred to as “Loss”) in connection with my/our use of Club Fit, its facilities, equipment or services. I/we waive any and all claims against the Indemnitees for any personal injury or property damage or loss relating to, arising from or connected with my use of Club Fit, its facilities, equipment or services, unless resulting from the negligence of Club Fit. I/my child hereby grant to Club Fit my/our consent and permission to use my/our photographs or other likenesses, entries, pictures, portraits, voices, testimonials, biographical information (in whole or in part), and/or statements made by me/us regarding the Club worldwide and in perpetuity for any and all purposes, including, but not limited to, advertising, trade and/or promotion on behalf of Club Fit, in any and all forms of media, now known or hereafter devised, including, but not limited to, print, TV, radio, electronic, cable, social media, or World Wide Web, without further limitation, restriction, compensation, notice, review, or approval. I/my child hereby release and discharge Club Fit from any claims and demands arising out of or in connection with such use(s), including but not limited to any and all claims for libel or invasion of privacy/publicity. This Agreement embodies the entire agreement between the parties with respect to the subject matter hereof and may only be changed by a written instrument signed by both parties. This release, waiver, and consent shall be binding upon me and my heirs, legal representatives and assigns. I accept all terms as outlined above