~ Classes in Glencoe, Mail to: Heart Center Yoga, 1060 Edgebrook Ln., Glencoe, IL 60022~
~ Classes in Highland Park, Mail to: Heart Center Yoga, 358 Hastings, Highland Park, IL 60035 ~
Names (Parents and Child)
Age of Child Birthdate ___
Address
Phone Numbers (Home) (Cell)
Emergency Phone Number
Email Address
Class Description, Day and Time
Amount of Class Fee______________________
Special
needs and health concerns, food allergies_____________________________________________________________
Please make check payable to Heart Center Yoga. 10% discount for siblings.
Fees (less $25 processing charge) are refundable up to and including first class