Encore Mat Yoga Class Survey

Thank you for your interest in the NEW mat yoga class at Encore. We’d like your feedback about the class in addition to getting a headcount of subscribers who are excited to join this group for the next 8 weeks. We are hoping to get a MINIMUM of 6 subscribers to support the class.

Name

First Name

Last Name

Email

Use this space to share feedback about your experience with the class on August 5 (if applicable)

Please let us know if you are interested in attending the MAT YOGA class at Encore on Tuesdays at 6:30pm with Amy.

Yes, I would like to subscribe (next 8 classes for $80 - SEE PAYMENT OPTIONS BELOW)

Yes, I plan on dropping in for classes ($13 each - you can bring check/cash or pay with Venmo)

No, I no longer plan on attending

I'm not sure

SUBSCRIPTION PAYMENT INFORMATION

1. To pre-register for the next 8 classes, you can complete the credit card payment fields below and $83 will be charged on your card ($80 + $3 fee). 2. You can pay $80 via Venmo to (@Brian-Critchley). 3. You can write a check for $80 made out to OM Central Jersey Yoga and mail it to OM Central Jersey Yoga, c/o Brian Critchley, 1253 Denmark Road, Plainfield, NJ 07062.

Name as it appears on card

Card Number

Expiration Date

Security Code

5- Digit Billing Zip Code