Dance Classes Registration

Thursday Horton Class Registration - Substitute Instructor Mekeba Malik

Please complete before arrival. Classes are 90 mins starting at 7:30pm, and held at the Chicago Multicultural Dance Center on the lower floor. (47 W Polk, Chicago)
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
How are you paying for class? [$20]
Cancellation
Should any issues arise and you are unable to attend a class that has already been purchased, please reach out via email to joshualishmon@gmail.com with your payment receipt and let us know if you'd prefer a refund or for that payment to rollover to cover the next class you attend.
Class date

MonthDayYear
Date
How did you hear about us?

Other
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.
Agreement
Date

MonthDayYear
Date
Should be Empty:

Thursday Horton Class Registration - Substitute Instructor Mekeba Malik