Schedule Appointment with ANAHATA CONSCIOUS LIVING

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Notes to Business (your address or any special notes about your order)

Item	Quantity	Total
5-Class Membership	x $110.00	$110.00 per month for 4 months ($440.00 total)
Total: $110.00	Coupon:

I understand that I must be in good physical health to participate in these classes, that my participation may cause an injury and that I should consult with my physician before I take a class. I am taking these classes at my own risk. I waive any claim for personal injury and any other damages that I may have against the school, studio and/or the teachers who are offering these classes. For studios or teachers that do have a website with a Terms of Use, which includes a release and waiver of liability, the disclaimer should read as follows:

I waive any claim for personal injury and any other damages that I may have against the schools, studio and/or the teachers who are offering these classes.