Pilates Group Mat Classes Registration Form

Please print and complete this form and mail with payment (check payable to "The Pilates Center") to:

The Pilates Center
312-H East Market Street, 2nd Floor
Leesburg, VA 20176

For further information, about mat classes, please call 703-779-3511.

  Returning Student
New Student / Updated Info
Name:
Street:
City:   State:   ZIP:
Day Phone:
Evening Phone:
E-Mail:
Class(es): Thursdays - 9am -9:50am Mixed Level Mat
Saturdays - 10am -10:50am Workshops TBA
Comments/
Questions:
Payment
Enclosed: $
Would you like a
mat class added
to our schedule?