Detroit Urban Ballroom Registration
Name
*
First Name
Last Name
Age
Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Gender
*
Male
Female 2
Non-Binary
Prefer not to say
Have you taken dance classes before?
*
Yes
No
Dance Level
Beginner
Intermediate
Advanced
Preferred Dance Style(s):
Hip-Hip
Ballet
Jazz
Contemporary
Ballroom
Swing
Latin
Tap
Do you have any medical conditions or allergies we should be aware of?
Waiver and Consent
*
I understand the risks associated with physical activity and release the organizers from liability.
I consent to emergency medical treatment if necessary.
I grant permission for photos/videos taken during the event to be used for promotional purposes.
Submit
Should be Empty: