REGISTRATION FORM

INSTRUCTIONS: 

  1. Please consider registering ASAP because space is limited in workshops.
  2. Complete the registration form below, print and mail with payment to:

Mark Grevelding/Fit Motivation
346 Douglas St.
Syracuse, NY 13203
markgrev@gmail.com

First Name
Last Name
Address 1
Address 2
City
State
Zip
Email
Telephone
 
Workshop
   
Method of Payment: Check   Visa  Mastercard
  

(Please make checks payable to Fit Motivation)
  
Amount Enclosed:
Credit Card Number
Expiration Date MM  YY
Name on Card
Signature
Comments or Special Instructions

  

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