Ceroc Buckingham Monday Class Contact Form
Please note that this form is not our booking system. This is purely a way for you to provide additional details for members booked onto Monday night socially-distanced Ceroc classes. Make sure you have already booked and paid for your couples tickets by clicking the link underneath:
https://www.network.ceroc.com/Applications/COS/PaymentModules/PM-FMO?e=5833
* Required
Email address
*
Your email
Emergency Contact Number
*
Your answer
Dates Attending
*
21 September
25 September Friday Workshops
28 September
5 October
12 October
19 October
26 october
Required
Leader's Name
*
Your answer
Leaders Membership Number
Your answer
Follower's Name
*
Your answer
Followers Membership Number
Your answer
Additional Contact Information
*
Partner's email or phone number
Your answer
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