SGUMC Dance Instruction Registration Fall 2017
Please complete the form below to register for the fall 2017 Wednesday Night at the Grove Dance class. *Please note that registration is not complete until Dixie has received your payment of $50 per couple. If you have any questions, please contact Dixie Chappell at
Participant Name (Person A)
Participant Name (Person B)
Email Address (Person A)
Email Address (Person B)
Cell Phone Number (Person A)
Cell Phone Number (Person B)
Names and ages of children attending Wednesday Night classes (If Applicable)
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