Belly Dance Class Registration Form
Please complete the form below. You will receive an invoice within 24 hours. Registration fee is due by March 1st. Registration is not complete until payment is received. Once your registration fee is paid, your slot is reserved!

Kassi Brent
Owner, Instructor
EcoLife Middle Eastern Dance Studio
Name *
Phone Number *
E-Mail *
Class *
If this is part of a "Mom and Me" registration, please list the name of the other dancer below. (Other dancer needs to fill out a separate registration form as well.)
Preferred Method of Payment *
I understand that I am committing to a one time payment of $60 due by March 1st. (Adjusted price for Mom and Me registration.) Payment is non-refundable. The class price for the month is $60 and includes 4 classes at one hour and 15 minutes each (March 4, 11, 15, 25). Please note our strange class schedule this month. March 15 class will be 3-4:15 (kids) and 3:45-5:00 (adults). If I am unable to attend a class, I will not be refunded any portion of the tuition fee. However, current students may schedule make-up lessons with Kassi for half of her private lesson rate. I commit to having a positive attitude during class and toward my classmates and will passionately support Kassi's desire for a safe space for girls and women to learn and explore the beautiful art of belly dancing. *
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