In order to complete your registration, Please read the following waiver and indicate below you have read and understood this document.

Question Title

* 1. I understand by agreeing, my signature is being transferred electronically, and I will not challenge the validity of the signature in any legal proceeding in which this document may be offered or used.

Question Title

* 2. Which Mindful Music & Meditation drop-in sessions do you plan on attending?

Question Title

* 3. Last Name

Question Title

* 4. First Name

Question Title

* 5. University ID No.

Question Title

* 6. Email

Question Title

* 7. Department

Question Title

* 8. Are you a UCLA Health/Med Center staff member?

Question Title

* 9. How long have you been attending Fitzone Classes?

Question Title

* 10. Have you ever attended a Mindful Music Session

Thank you for planning to attend! We hope you enjoy the rest, relaxation and healing benefits of live, classical music and meditation.

T