Demographics: Number of people in your household: 1 2 3 4 5 6 7+

What is the age range of people in your household? (please enter the number of people in each age category)

0-2   3-5  6-9  10-14  15-19  20-35  35-50  50+

Program Interest:

Infant - Toddler Programs:

a) Baby Fit – Parents with children ages 0-3 – Work out with your baby for special parent/child bonding time

                        I am interested   I would prefer  Morning  Afternoon  Evening classes

                        I would be willing to pay $35 for 8 weeks

b) Kinder Play – Children ages 1-5 – An hour of fun and games while interacting with other children.

            I am interested   I would prefer  Morning  Afternoon  Evening classes

                        I would be willing to pay $35 for 8 weeks

c) On My Own – children ages 2-5 – A chance for your child to take their first steps towards being away from their parents. 

            I am interested   I would prefer  Morning  Afternoon  Evening classes

                        I would be willing to pay $35 for 8 weeks

d) Music Makers – Parents with children ages 1-4 – Shake maracas, beat drums, ring bells and play with a parachute, all while learning simple musical concepts and theory.

            I am interested   I would prefer  Morning  Afternoon  Evening classes

                        I would be willing to pay $90 for 10 weeks

e) Sport Ball – children ages 16M-2 – Children & parents participate in sports, creative games, songs and much more!

            I am interested   I would prefer  Morning  Afternoon  Evening classes

                        I would be willing to pay $90 for 6 weeks

Child and Youth Programs

a) Dance – children ages 3-12 – Programs focusing on Ballet, Hip Hop and Jazz.

                        I am interested   I would prefer  Morning  Afternoon  Evening classes

                        I would be willing to pay $35 for 8 weeks

b) Gymnastics – children ages 3-5 – Introduces children to the fundamentals of gymnastics

            I am interested   I would prefer  Morning  Afternoon  Evening classes

                        I would be willing to pay $40 for 8 weeks

c) Art – children ages 3-12 – Introduction to the world of art that will encourage creativity and self-expression.

            I am interested   I would prefer  Morning  Afternoon  Evening classes

                        I would be willing to pay $35 for 8 weeks

d) Floor Hockey – youth ages 9-12 – Learn new skills, meet new friends and play organized games of floor hockey.

            I am interested   I would prefer  Morning  Afternoon  Evening classes

                        I would be willing to pay $35 for 8 weeks

e) Indoor Soccer – children/youth ages 6-12 – Keep your soccer skills in shape until the spring season, or just play for fun!

           I am interested   I would prefer  Morning  Afternoon  Evening classes

                        I would be willing to pay $35 for 8 weeks

Adult Programs

a) Cardio Fitness – ages 18+ - Come blast calories and increase your cardio endurance.

            I am interested   I would prefer  Morning  Afternoon  Evening classes

                        I would be willing to pay $35 for 8 weeks

b) Senior Fitness – ages 50+ - Slow and controlled movements that are easy to follow and safe for all ages.

            I am interested   I would prefer  Morning  Afternoon  Evening classes

                        I would be willing to pay $35 for 8 weeks

c) Yoga – ages 18+ - Sequence of standing and seated postures designed to help relax, strengthen and stretch.

            I am interested   I would prefer  Morning  Afternoon  Evening classes

                        I would be willing to pay $50 for 8 weeks

d) Volleyball – ages 18+ - Recreational volleyball for participants of every skill level.

            I am interested   I would prefer  Morning  Afternoon  Evening classes

                        I would be willing to pay $30 for 8 weeks

(Please tell us of any other ideas for programs that you think people would be interested in)

OPTIONAL:

If you wish to have us contact you about any of the above, please include your contact information here:

Name:

Email:

Phone:

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