Dance Classes Registration

Social Salsa Registration Form

Monday’s 6.30 Beginners, Mondays 7.30 Improvers, 19 Turua Street, St Heliers
Name*

First NameLast Name
Gender*

MaleFemale
Age Bracket

Under 3030 - 4545 - 60Over 60
Phone Number*

Area CodePhone Number
Email
example@example.com
Suburb you live in
Level of Previous Dance Experience any Style

Two Left FeetBeginnerImproverIntermediateAdvanced
Medical Conditions or Allergies
Terms and Conditions:

By submitting this form, I acknowledge that participation in dance classes involves physical activity and I hereby release the dance studio and its instructors from any liability for injuries or accidents that may occur during classes or events.
Signature

Clear
Date signed

DayMonthYear
Date
Should be Empty:

Social Salsa Registration Form