Bellydance with Jeylan Summer Registration
Please complete the following to register for summer bellydance workshops with Jeylan at Two Left Feet Dance Studio in Newport News, VA. For questions or more information, please email, call/text 757-912-5591, or go to
Email address *
First and Last Name *
Your answer
Preferred Phone Number (in case of class changes) *
Your answer
May Preferred Phone receive texts?
I am registering for the following workshop/s. *
Workshop Fees
Workshops cost $30 each. If registered at least one week in advance the price drops down to $25 each. If registering for two or more workshops by Saturday, June 22, 2019, the price drops again to $20 per workshop. $10 drum rental available for August workshop if registered by Sunday, 8/18. Fees due at the start of each workshop. Paypal is preferred; please send to Checks payable to Rachel Bevins and labeled cash are also accepted in person or may be mailed (please request snail mail address).
By completing my name below and submitting this form I agree to abide by the pay schedule and will inform the instructor of any absences as soon as possible. I will not hold Jeylan, Rachel Bevins, or Two Left Feet Dance Studio liable for any injuries occurring to me during classes or related times. (Type name) *
Your answer
Today's Date *
How did you hear about Jeylan's workshops?
Your answer
Dance Experience (types, approximate amount of time or level)
Your answer
Why are you interested in taking this workshop/s? What would you like to accomplish?
Your answer
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