Contact Us

Name

Birth Date: Month Select Month January February March April May June July August September October November December Day 01 02 03 04 05 06 07 08 09 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31

Address

City State AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip

Daytime Phone

Evening Phone or Cell

Email Address

Yoga classes (select all that apply) Mon Wed Thurs Fri

Please read the Registration Agreement below and enter your intials before submitting.

I have read and agree to the Registration Agreement .

Registration Agreement

I understand that yoga may be physically challenging, that I am aware of the affects it may have on my body and my health, and I have discussed my participation in such classes with my personal health practitioner. I understand the flexibility of my child and agree that my child is in good health. While participating in, or as a result of yoga classes, I agree to maintain responsibility for myself and/or my child’s own well being, physical and mental health. As an instructor, I will take 2-3 weeks off per year. At this time I will provided a sub instructor for some of the classes during those weeks. There are major holidays which are recognized; New Years, Easter, Memorial Day, 4th of July, Labor Day, Thanks Giving, and Christmas. Classes will not be held unless otherwise instructed.

Directions

We are located at 5995 N U.S. HWY-1, at the NE corner of U.S. HWY-1 and Pineda Cswy, Melbourne, FL 32940. Pineda Landing is across from Harley Davidson.

Driving Directions to Yoga on the River compliments of Mapquest.com