Personal Information First Name (*required) Last Name (*required) Address * City * State * Zip * Email * Phone Mobile Select Class ---Next Available Class: TBA METHODS OF PAYMENT DIRECT DEPOSIT Requires Zellepay App Use email address: *protected email* WHAT'S ZELLEPAY? MAIL PAYMENT Mail to: Optimal Wellness Solutions 5195 Sevenoaks Dr. Colorado Springs, CO 80919 PAY BY PHONE Call 719-590-9879 to provide Credit Card Information Comments/Questions