Registration

Already a customer? Click here to login.

U-Jam Fitness® is an athletic urban dance fitness workout that combines dance and high energy music for a workout that is bound to get your heart rate up, your body moving, and make you work up a sweat -- all while having FUN! Come join us on April 19th, from 7:00 - 8:00 pm for an amazing class with Kelz. This class is open to adults and kids 9 years and older.

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

Room:

* - denotes required fields

Family Information

	First Name:*	Last Name: *
	Parent
	Home Phone:	Cell #: Work #:
	Email:*	(Emails are kept confidential)

	Address: *
	City: *	State: * Zip: *

Students entered below will be added to your family's account

Additional Information:

Other Questions/Comments:

Credit Card Verification:

Card Number: *

Name as it appears on card: *

Nickname:

Card Expiration Month: *

Exp Year: *

Address Line 1:

Address Line 2:

City:

State: Zip:*