Pilates Group Mat Classes May - June 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):

Beginner Mat - Mondays 6:30 - 7:20PM
Beginner Mat - Thursdays 9:30 - 10:20AM
Beginner Mat and Stretch - Saturdays 10:00 - 10:50AM
Advanced Beginner Mat - Tuesdays 6:30 - 7:20PM
Advanced Beginner Mat - Saturdays 9:00 - 9:50AM
Intermediate Mat - Fridays 9:30 - 10:20AM
Intermediate Mat - Saturdays 9:00 - 9:50AM
Intermediate/Advanced - Mondays 7:30 - 8:20PM
Mat PLUS (Stretching and Roller work) - Tuesdays 9:30 - 10:20AM
Mat PLUS (Stretching and Roller work) - Thursdays 6:30 - 7:20PM

Comments/
Questions:
Payment
Enclosed: $
Would you like a
mat class added
to our schedule?