Zumba/Cardio Dance Registration Form

Zumba/Cardio Dance Registration Form

Cinco Ranch Lakehouse 25202 Springwood Lake Dr. Katy, TX 77494
Student Name*

First NameLast NameNickname (optional)
Birth Date*

MonthDayYear (optional)
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Student E-mail*
example@example.com
Phone Number*
Are you willing to receive texts?
Preferred Contact Method
Would you willing to be included on group texts?
Group texts will be used to communicate schedule changes, special events, and other important information.
CLASS PACKAGE OPTIONS*
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SALSA PACKAGESALSA PACKAGE/Up to 30 classes/90 days
$249.00 Quantity



MAMBO PACKAGEUp to 20 classes/90 days
$199.00 Quantity



MERENGUE PACKAGE4 classes/month
$48.00 Quantity



BACHATA PACKAGEIndividual Class
$15.00 Quantity



FREEstyle PACKAGEFree Trial Class
$ Free Quantity



Total

$0.00
- All Classes are 60 minutes long.
- Pro-rated monthly payment option available for SALSA and MAMBO packages--additional $20/month to 90 day package pricing.
- CLASS SIZE IS LIMITED!--1st come/first serve
Accepted Payment Options
CHANGES TO CURRENT CLASS SCHEDULE: If there are days/times that you are NOT able to attend due to a schedule conflict, please check those boxes below. I will use this information to request schedule changes in the future if the majority of students are not available.

Mondays 6-7 pmWednesdays 6-7 pmThursdays 10:30-11:30 a.m.
What days/times (mornings/afternoons/evenings) would you like to have classes in the future?
How did you hear about these classes?
Are you new to Zumba? (No experience is necessary!)
You must complete the following waiver before you take your first class:

https://crswcc.wufoo.com/forms/z19dvzxg0c8t80u/

Please bring this waiver to the first class--you can either print it out or take a screenshot and present it.
QUESTIONS?

Please call me at: 713-806-7561 OR email me at cardiodancewithrenee@gmail.com

I CAN"T WAIT TO DANCE WITH YOU!
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