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* 1. Which Tread Trainer course would you like to be place on a wait list?

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* 2. Please fill out the following information.

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* 3. Do you belong to an organziation or and or work for the goverment. If so please let us know your affiliation.

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* 4. Contact Phone:

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* 5. Email Address:

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* 6. How did you hear about this course

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* 7. What is your top area of interest

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* 8. Please add any questions or comments here.

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* 9. This course is free but a $25 Deposit is required. If a space opens up you will contacted by Tread Lightly! staff within for information related to the deposit. Please be prepared to provide a credit card number. Your card will not be charged unless you cancel within 14 days of the course and or do not show up for the workshop.

I have read and understand the above statement

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