Name *
Email Address *
Add me to your email list *
 Yes 
 No 
Telephone Number *

WEDDING PROGRAM

Wedding Choreography
 Yes 
 No 
Date of Wedding

MM		/
DD		/
YYYY

PRIVATE LESSONS

Book a Private Class
 Yes, please! 
Number of People
Date and Time Requested

MM		/
DD		/
YYYY
HH		:
MM
AM/PM
We can not guarantee times but will do our best.
Dances Requested
Let us know what you would like to learn in your Private Class.

GROUP CLASSES

Group Class Name
Please refer to our Class Schedule for details of upcoming classes. If you are signing up for multiple classes, please add details in the Comments box below.
Number of People
Location
 Augustana Lutheran Church 
 CUMC 
 Williamsville North High School 
Group Class Start Date

MM		/
DD		/
YYYY

SPECIAL EVENTS

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