Jamie G. Smith.com :: REGISTRATION FORM

REGISTRATION FORM

Please a contact me for more information or with any questions you may have.

Events:

First Name:

Date:

9/9/2010 7:14:17 AM

Middle Initial:

Last Name:

Street Address:

City:

State:

Zip:

Phone:

Email:

Where do you teach or train?
What classes do you teach or train?
In what Group Fitness Certifications are you current (ACE, AFFA, etc)?

Send your payment to:
Jamie G. Smith
P.O. BOX 1748
Castle Rock, CO 80104

***workshop/class fee is non-refundable