Private Lesson Client Inquiry
Please note that a 50% deposit is required in order to secure lesson date/time
Host:
*
First Name
Last Name
E-mail:
*
Is this for a special occasion?
ex: Anniversary, Birthday, etc.
Expected Number of Attendees:
*
Please Select
1
2
3
4
5
6
Private lessons allow a maximum of up to six (6) guests; please include yourself in the count
Phone Number:
*
Your Address:
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Venue Location (if we are traveling to you): please leave blank if you are traveling to our studio
Street Address
Suite
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
Private Lesson Package (90 minute package; 75 minute class time):
*
Just Me ($100)
Me + One Homie ($100 total / $50/pp)
Me + Two Homies ($125 total / $42/pp)
Me + Three Homies ($150 total / $37.50/pp)
Me + Four Homies ($175 total / $35/pp)
Me + Five Homies ($200 total / $33/pp)
Class Style: (one style max)
*
AfroBEATS
Chair Dance
Lap Dance
StripTEASE
Struttin in Stilettos
TWERKfit
Yoga
Other
Preferred Date & Time:
*
/
Month
/
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Secondary Date & Time:
*
/
Month
/
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Song Choice/Artist:
Popular artists include: Beyonce, Trey Songz, Chris Brown, Rihanna, Giveon, Jeremih, Neyo, Tank, Summer Walker, H.E.R., Janet Jackson, Jacquees
Comments:
Please include any pertinent details regarding this lesson.
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