Name *

First Name

Last Name

Are you a Texins member? *

Yes

No

No, but I'd like more information on this

Building Name or Location *

NOTE: TI Family Memberships, Contractors, Co-locaters & Retirees should choose "TEXINS"

DMOS5

DMOS6

Kilby East

Kilby West

Research East

Research West

RFAB

SC Building

Sherman

South Building

South Campus - Forest Lane

TEXINS - TI Family Memberships, Contractors, Co-locaters & Retirees

Facilities

Maine

LFAB

Sugarland

Santa Clara

Tucson

Select the dates you are registering for *

Select all that apply.

Jan 9

Jan 16

Jan 23

Jan 30

Feb 6

Feb 13

Feb 20

Feb 27

Mar 6

Mar 13

Mar 20

Mar 27

Please choose your form of payment. *

Payroll Deduction (REQUIRED for TI Employees and TI Family Members). By selecting this option you are authorizing Texins to proceed with a $5 PER CLASS for NON TEXINS members payroll deduction charge that will be submitted the day after each class you are registered to participate in.

Credit Card (REQUIRED for Co-locaters, Contractors & Retirees). Please provide credit card payment at the front desk at Texins Fitness Center on or before each class you're registered to attend. If payment is not provided by the deadline you will not be able to participate in the Qigong class.

Opt in to receive future communications on departmental offerings.

Select all that apply.

Aquatics

Fitness Programs

Group Fitness

Nutrition

Rec Leagues

Texins Events

Youth and Camp