Social Dance Registration
Student Information
Full Name
*
First Name
Last Name
Full Name
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State
Zip Code
E-mail
*
Contact Number
*
-
Area Code
Phone Number
please select the date of the social dance you will be attending
*
-
Month
-
Day
Year
Date
section separator for the form style - do not remove
Will tickets be available at the door?
Tickets will be available at the door for an additional $5 - cash only
Group Class Tickets:
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( X )
Current Member
Free
$
Free
Students that are enrolled and currently taking private dance lessons at one of our Prestige Ballroom locations
Non-Member Single
$15.00
$
15.00
Non-Member Couple
$25.00
$
25.00
Enter coupon
Apply
Subtotal
$0.00
$
0.00
Tax
$0.00
$
0.00
Total
$0.00
$
0.00
Payment Methods
Credit Card
Apple Pay
After submitting the form, you will be redirected to Apple Pay to complete the payment.
Google Pay
After submitting the form, you will be redirected to Google Pay to complete the payment.
Cash App Pay
After submitting the form, you will be redirected to Cash App Pay to complete the payment.
SUBMIT
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