Sterling Yellow Belt Registration
* Denotes required field	Please register by completing the following:
Name Prefix:	Mr. Miss Mrs. Ms. Dr.
First Name*:
Last Name*:
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Yellow Belt Registration Fees: $245.00
Select:	14-August-2015 Yellow Belt Ft. Lauderdale 29-Sept-2015 Tallahassee
Do you have Special Needs or Dietary Restrictions? Yes NO	Describe Below:
Select a Payment Method:
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SUBSTITUTION/CANCELLATION POLICY: The maximum number of attendees for this program is 40 per class. The program is offered on a first come basis. For additional questions about the program and schedule, contact the Sterling Office at (850) 922-5316. No refunds. Only substitutions allowed prior to the first session. Dates subject to change due to class registrations. By clicking the Submit Registration Button, I acknowledge that I have read, understand, and agree to be bound by this substitution / cancellation policy.
PLEASE PRINT THIS FORM FOR YOUR RECORDS
Questions? Call 850-922-5316