Water Aerobics Programs Registration

All registrations must be received no later than the Tuesday before the start of the block. All blocks must have at least 2 students to be held. If the class does not have enough students we will contact you. If you have any questions please email Robin Harden at rlharden@kirksvillecity.com

All Fields are REQUIRED. An email confirmation will be sent once your registration is received.

Please supply the following information:

Participant's Name:

Daytime Phone Number:



Evening Phone Number:



Email:



Please select which class and session(s) you are registering for



Aquatic Boot Camp

Deep Water Aerobics

Monday & Wednesday: 5:30-6:30PM

Tuesday & Thursday: 7-7:45PM

      Block 1: June 4-June 27
       Block 1: June 5-June 28

      Block 2: July 9-August 1        Block 2: July 10-August 2

Please use the space below to supply additional information:

Participant's Name:
Daytime Phone Number:
Evening Phone Number:
Email:


Please select which class and session(s) you are registering for



Aquatic Boot Camp	Deep Water Aerobics
Monday & Wednesday: 5:30-6:30PM	Tuesday & Thursday: 7-7:45PM
Block 1: June 4-June 27	Block 1: June 5-June 28
Block 2: July 9-August 1	Block 2: July 10-August 2

Please use the space below to supply additional information:

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