Survival Fitness Spring 2025 - NEW ULM

First and Last Name *

First Name

Last Name

Phone *

(###)

###

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I confirm that I am a breast cancer survivor. *

Yes

Survivor Commitment

Participants are expected to attend 80% of the classes to be eligible for continued support after SF has ended. These fees are the responsibility of each survivor.

Yes, I agree.

I am not able to make this commitment but would like to participate in as many classes as I can.