POLE ASSESSMENT REQUEST FORM
1823 George Washington Way • RICHLAND, WA
PLEASE COMPLETE THIS FORM TO RECEIVE A COMPLIMENTARY AERIAL LEVEL ASSESSMENT
Skip Pole 101 & jump into classes!
All Forms will be answered via email.
Please check your email and junk mail.
Name
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First Name
Last Name
Are you over the age of 18? (all classes are for 18+)
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Yes
No
Email
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Phone Number
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Please enter a valid phone number.
Social Media Handles (Instagram, Facebook)
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Please select the option that best describes you:
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I'm on vacation in Tri-Cities and want to Pole while traveling
New or Local to the area with current Pole experience, wanting to try a new studio out!
I used to take classes but haven't done Pole in awhile. I'm unsure of my current level
Other
What aerial apparatuses do you have experience in?
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Pole
Silks
Lyra
Other
Please select your pole level
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Pole Level 1/2 (can perform basic moves+)
Pole Level 3/4 (can invert+)
None
Other
Please select your silks level
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Pole Level 1/2 (can perform basic moves+)
Pole Level 3/4 (can invert+)
None
Other
Please select your lyra level
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Pole Level 1/2 (can perform basic moves+)
Pole Level 3/4 (can invert+)
None
Other
How long has it been since you practiced aerial arts?
Less than 6 months
Less than 1 year ago
It's been a hot minute
Please list a couple of the recent moves you have been working on, if known:
Who can we thank for telling you about Wonderland Pole and Dance?
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WE ARE SO EXCITED TO MEET YOU & WE CAN'T WAIT TO DANCE WITH YOU SOON!
Pole Assessments are scheduled during Open Play times only. Please download the Bookee app and search "Wonderland" to see our current Open Play schedule.
WE INVITE YOU TO FOLLOW US ON INSTAGRAM & FACEBOOK @wonderlandpole
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