Lakewood School - Application for Admission
Please select any of the following that pertain to you:
High Blood Pressure
Chronic Back Pain
Tumors or Cysts
Please explain selected items:
Is ongoing medical supervision required?
Currently taking medication?
How did you learn about Lakewood School?
Have you received a one-hour professional massage?
Date / Name of Therapist
Have you ever been convicted of a felony?
Please select your program choice:
Fall Program (August-June): Tuesday Day Class
Program (August-June): Monday/Thursday Evening Class
Winter Program (February-December): Thusday Day Class
I hereby state that all of the above information is true to the best of my knowledge
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