Registration: To register, return this form along with your check or credit card information to:

Life Trax – 17017 East Warren Pl. unit B, Aurora, CO. 80013.

Fax: (303) 284-6277 Phone: (303) 568-9420.

Class Title: _________________________________________ Date: _________

Number of Participants: _____________ Total Amount:______________________

Participants' Names ________________________________________________
_______________________________________________________________
_______________________________________________________________
_______________________________________________________________

To charge registration, please provide the following information:

Visa / MasterCard (please circle one)

Card Number: ________________________ Exp. Date: ___________________

Name on Card: ___________________________________________________

Address: ____________________________ City/State/Zip: ________________

Phone: ___________________________ E-mail _________________________

If for any reason the Life Trax cancels a class, a full refund of registration fees will be made.
Full Refund minus 20% for participant cancellations (must notify one week before class start date).

www.lifetrax.org