Wedding Dance Workshop Registration

Group Lessons/Wedding Dance WorkshopsPrivate Lessons
If you would like to take a Private Lesson instead of a group lesson - register here.
Name*

First NameLast Name
Partner Name

First NameLast Name
E-mail*
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Format: (000) 000-0000.
Emergency Contact*

First NameLast Name
Emergency Contact Phone Number*
Format: (000) 000-0000.
Wedding/Event Date

MonthDayYear
Date
Please list any medical conditions, injuries, or allergies that could affect your safe participation in Northern Plains Dance activities.
How did you hear about us?

Choose your workshop dates & number of attendees*

Wedding Dance Workshop - Couple

$120.00

Select Your Workshop Dates	Quantity
Fridays \| April 10-May 1, 2026 \| 6:30-7:30pm (No Class on Good Friday)
Wednesdays \| June 3-24, 2026 \| 6:00-7:00pm

Wedding Dance Workshop - Individual

$60.00

Select Your Workshop Dates	Quantity
Fridays \| April 10-May 1, 2026 \| 6:30-7:30pm (No Class on Good Friday)
Wednesdays \| June 3-24, 2025 \| 6:00-7:00pm

Enter coupon

Total

$0.00

NPD collects basic demographic information for federal grant purposes only. This information will be kept anonymous and confidential.
Number of People in Household
Total Household Income
LIABILITY RELEASE
I hereby release Northern Plains Dance (NPD), its agents, and employees from any and all liability for personal injury, illness, or property damage that may occur on or off premises owned, rented, leased, or used by NPD. I certify that I am in good health and capable of participating in all classes and activities.

MEDICAL RELEASE
In the event of an emergency and if I cannot be reached by telephone at the number(s) provided, I authorize NPD, its employees, and agents to transport and admit me or my partner to a local hospital for emergency medical treatment. I release NPD, its employees, and agents from any liability related to such transportation and medical care.

PHOTOGRAPHY RELEASE
I grant permission to NPD to take photographs and/or video recordings of me and/or my partner, which shall become the property of NPD. I consent to the use of these images for promotional purposes.

ACKNOWLEDGEMENT
I have read this release in its entirety. I fully understand its contents and agree to be legally bound by it.
Signature*
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