Tai Chi Registration Form

Registration & Payment

Classes are offered in 6-class terms for $150 ($25 per class). To receive the term rate, registration and payment must be completed on or before the first class of the term. For a list of Term Start Dates, click here.

After the term begins, registration is available by drop-in only at $30 per class.

Payment can be made:
- Online through this form (at the bottom)
- In person by cash, cheque, debit or credit before the start of class
- By e-transfer to churchoffice@rosedaleunited.org in advance of your class. Be sure to include the class you are registering for in the notes section.

If you have any questions about your registration, please email churchoffice@rosedaleunited.org.

Name

Address

This address will receive a confirmation email

Phone

Emergency Contact

Emergency Person

Spouse Adult Child Adult Grandchild Sibling Family Friend Caregiver

Emergency Contact Name

Emergency Contact Cell Phone Number

Do you have any allergies or medical conditions we should know about?

Yes No

If yes, please list

PHOTO CONSENT: To promote our program, we may capture photos/videos during class activities. These images may be used for promotional materials (flyers, posters, brochures), organization website, social media platforms, newsletters and reports.

Yes, I give permission to be photographed, video recorded, and have my image used for the purposes stated above. I understand these images may be shared publicly. I understand that no personal information (e.g., full name) will be shared without addition No I do not give permission

Which class are you enrolling in?

Tai Chi - Beginner Level Tai Chi - Intermediate

Payment

If drop-in class, what date?

If paying for term, which one?

Credit/Debit Card Number

Expiration Date/CVC

Name on Card Card Billing Address

Tai Chi Registration Form

Description

Please Fix the Following