Name *

First Name

Last Name

Phone *

Country

(###)

###

####

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Aerial Membership class fees *

Gym Club members get a 20% discount on Aerial classes

Private class 90 minites 1,000 bart

Private package class 10+1 - 10,000 bart

Group class 90 minites - 370 bart

Group class package 10+1 - 4000 bart

Start Date *

MM

DD

YYYY