mBody Dance Workshop Registration Form
mBody's Winter Workshop, January 4th hosted at Katie's Dance Studio, El Cerrito, CA. Please fill out information below prior to attending worksop.

Payment will be due on the day of the workshop(cash, card, paypal, venmo or check). Please email mbodydanceco@gmail.com with any questions! See you there!
Email *
Dancer's First and Last Name: *
Dancer's Birthdate: *
Years of dance experience: *
Dancer is currently registered at Katie's Dance Studio? *
Select which classes you would like to attend or Full Day Below: *
Select your preferred form of payment below: *
I hereby give my, or for my child under 18, permission to have my/their photo or video used for professional, promotional or advertising purposes with mBody Dance Company only. *
Emergency Contact: Name, Number, Relationship to Child *
Please check our website for any updates you may need prior to the workshop! We look forward to moving and dancing with you!! Feel free to email us at mbodydanceco@gmail.com with any questions! ~mBody Dance Company
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