Registration Form
Fill out the form carefully for registration
Student Name
*
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Student E-mail
*
example@example.com
Mobile Number
*
Phone Number
Monclova Community Center Courses
*
Monday Beginner Line Dance Session - (4 weeks) - November 4th, 11th, 18th, & 25th from 5:30-6:30
Monday Intermediate Line Dance Session - (4 weeks) - November 4th, 11th, 18th, & 25th from 6:30-7:30
Class Times: Beginner 5:30-6:30, Intermediate 6:30-7:30
Fee
$40 payment for the 4 week session is due in full upon arrival to the first class. Cash only.
Submit
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