Contact

Name *

First

Last

Address

Phone

Email *

Waiver: *

• I will in no way hold Jacqie Stathis or any instructor listed on this website responsible for any personal injury or ailment due to strenuous activity or exercise. I am aware of all the risks associated with physical activity and state that I am in good health, and have seen a physician for approval for any exercise I participate in.

Email

Submit