A Night Under The Stars Gala - Registration form
Dear guest, please fill in this form to register for the WuBDA Gala at June 14 2019!

Note that registration will not be final until the payment has been received!

Email address *
First + Last name *
Your answer
Telephone number *
Your answer
I agree to transfer €16 to NL16 INGB 0007 357 279 held in the name of Wageningen Ballroom Dance stating my name and 'Gala' *
Privacy. I agree that the information provided by this form will be used by the Gala organization only for gala-related causes. I also agree that photos will be made during the gala and shared on WuBDA media platforms for promotion. *
From which dance association are you?
Your answer
Place of residence *
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