Country Western Dance with a Partner or without! The two-step, polka, waltz and jitter bug will be covered during this 6 week session. Childcare is available at $50 additional fee per child during the class for the full 6 weeks. No refunds. Fee is per couple. Single is the same price as a couple. *REGISTRATION IS PER COUPLE or a single, not family as indicated on the form.* Class meets every Sunday starting September 22 - October 27 from 5-6pm.
Start Date/Time: End Date/Time:
Fee per Family: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
Home Phone: Cell #: Work #:
Email:* (Emails are kept confidential)
Address: *
City: * State: * Zip: *
Emergency Contact Info (Not Contact #1 or #2)*
Will you be a couple or individual?*
What are both names of the couple participating?*
Are there any medical conditions that we should be aware of? If you please indicate in the comments below*
Will you need childcare?*
Names and Ages of Children to participate in childcare. *$50 fee will be charged at registration for each child*
Additional Information:
Other Questions/Comments:
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