MOVE FOR A MISSIOn STUDIO INTAKE FORM Name * First Name Last Name Studio name * Contact info * Please provide your best form of contact. DATES + TIMES AVAILABLE * List all of the dates + times you'd be able to host a 1-hour class from November 15th - December 15th. Location If you have multiple locations that are available to participate, please list them here. CLASS SIZE * What is the maximum # of students you can host? # OF CLASSES If you are able and willing to host more than one class, let us know how many. LIABiLITY WAIVER Do you need a liability waiver? Yes No Target age group * Select as many as you'd like. 18+ High School Middle School Elementary Social Media Handles We'd love to tag you to help promote! Thank you for joining the movement! We look forward to serving our community with you and will be in touch soon.