Wedding Dance Course 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
Location you will be taking your lessons at
*
Please Select
North Canton
Hudson
How did you first hear about us?
*
Please Select
Google
Facebook
Sign / Location
Friend (Please list their name in the box below
Event
Gift Certificate
Maps Search
Other (Please specify in the box below)
Name of your friend
blanks
Other
blanks
section separator for the form style - do not remove
Class Options:
prev
next
( X )
`A La Carte Wedding Lesson
$120.00
$
120.00
Just need a quick 1-3 lesson refresher? Our `A La Carte Wedding Lesson is for you!
Quantity
1
2
3
Item subtotal:
$0.00
$
0.00
Pearl Wedding Dance Course - 4 Private Lessons
$420.00
$
420.00
Diamond Wedding Dance Course - 8 Private Lessons
$840.00
$
840.00
OUR MOST POPULAR WEDDING DANCE COURSE.
Platinum Wedding Dance Course - 12 Private Lessons
$1,260.00
$
1,260.00
Enter coupon
Apply
Subtotal
$0.00
$
0.00
Tax
$0.00
$
0.00
Total
$0.00
$
0.00
Credit Card
SUBMIT
Should be Empty: