Private Class Registration Form
Please fill the form out thoroughly so we can get to know you better!
Your Name *
Your answer
Contact info *
Phone #, e-mail, address. If there are more than one of you, please list everyone's information.
Your answer
What is a convenient time to reach you? *
i.e. any evening after 6PM
Your answer
Please list your preferred times to schedule private classes. *
i.e. Wednesday evenings after 6PM
Your answer
Goals *
What do you want out of these private classes?
Your answer
Medical Considerations
injuries, arthritis, back problems, previous strokes, diabetes, mobility issues, physio
Your answer
Physical Ability and Aptitude *
Dance experience, physical activities you do, how active are you, do you play sports?
Your answer
Would you be looking to learn with us over the long-term? *
How did you find out about us? *
Your answer
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