CLASS SELECTION FORM (Classes are filled first-come, first-served.)
Full payment must accompany the registration form and must be received at least one week prior to the first day of classes.

Student's Name ____________________________________________
Age   __  Birthdate  _______
Street Address ________________________________________________
City/State/Zip _________________________________________________
Home Phone Number ______________________ 
E-mail  ___________________________
Medical conditions or allergies ____________________________________
Food allergies or intolerances _____________________________________
New students - how did you hear about Prana?  ________________________
If under age 18: Grade  ____  Parents’ Name(s)_______________________________
Parent's Cell Phone _____________________________
Second Parent Cell Phone ______________________________
Any other phone number where parent can be reached during class ______________________
Anything you would like us to know about your child ______________________________________

Please read/sign the following. Your signature indicates you have read, understand and agree to comply with the statements listed here. 

I release the Prana Center and staff from all liability in connection to any personal injury and/or damage to or loss of personal property while engaged in class activity or walking to/from class. In the event of a medical emergency, I grant the staff permission to engage in first aid  and if necessary to transport or have me/my child transported to the nearest Emergency Medical facility.   

It is my responsibility to cover any fees resulting from a check which has been returned by the bank. My money will be refunded only if I or my child cannot be registered due to overenrollment or cancellation.  If an exception is made, a $25 processing fee will incur. 

I give Prana Center  permission to use pictures of myself or my child in publicity and/or on their website or other associated electronic media.

Date ____  Signature of Parent/Guardian ______________

Prana Productions and Classes
[ ] Teen Harmony Workshop $189
[ ] The Legend of Sleepy Hollow $375 (Summer Stock)
[ ] Arsenic and Old Lace $375 (Summer Stock)
IF signing up for a camp session as well as Summer Stock, you will qualify significant discounts.  Use the Camp Registration Form to sign up - choose 3, 4 or 5 weeks (if signing up for all 6 weeks, the additional week is just $275).  * Email robertamweiner@gmail.com with any questions

All other classes and productions are currently full.  Check back soon for details on our Spring Musical!

Or join our mailing list by emailing robertamweiner@gmail.com

Adult Yoga:
[ ] 10-class Yoga Card - $125 - good for any adult class!  Teens and serious children welcome.
[ ] 25-class Yoga Card - $250 - good for any adult class!  Teens and serious children welcome.

Please make check payable to Prana Center. Mail to Prana Center, 21 Charles St., Holliston, MA 01746. 

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