Registration

To register for a class, fill out the form below. Once you have completed and submitted your form, mail check to:

Paula Shackelford
PO BOX 11406
El Dorado AR, 71730

NOTE: This form does NOT guarantee your spot. Once the check is received, you will be notified and registration will be completed.
If you have any questions, feel free to give me a call: (870) 444-4051

REGISTRATION FORM

* Indicates required field

Name *

First

Last

Phone Number *

Email *

Kickstart Your Health - 7 Week Series - $97 Per Person (First Class Monday April 9th - 3:30 PM)

Submit

To finish registration send a check to:

Paula Shackelford
PO BOX 11406
El Dorado AR, 71730

NOTE: This form does NOT guarantee your spot. Once the check is received, you will be notified and registration will be completed.
If you have any questions, feel free to give me a call: (870) 444-4051

Registration

REGISTRATION FORM

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