EmailMe Form - Brasil's Group/Private Lesson Request

Contact Name *
First Last
Contact Phone *
### - ### - ####
Contact Email *
Contact Method *
Date Requested *
MM / DD / YYYY
(please allow at least 48 hours notice)
Type of Lesson *
Private Lesson (1-2 people)
Group Lesson (3-15 people)
Group Lesson (16 or more)
Special Events
Type of Event
Bachelorette Party
Birthday Party
Girls Night Out
Work Party
Other
Name of Honoree
VIP Bottle Service?
Yes
VIP section includes free entrance to the club and lounge section for 10 people. Requires purchase of 3 bottles from our menu.
Please provide us with any additional info: