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Student's First and Last Name
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Student's Date of Birth
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Parent's/Guardian's First and Last Name
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This field is required for children students only. Please fill in N/A if the student is an adult.
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Address
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Email
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Cell phone
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Emergency Contact Information
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Include first and last name, and a phone number
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Select Class
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Hoop Dance & Fitness Adults - Saturday 10:00 am (Mandeville)
Hula Hoop Dance for Kids (7+ yo) - Tuesday 4:45 pm (Mandeville)
Hula Hoop Dance for Kids (5-6 yo) - Saturday 1:00 pm (Mandeville)
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