Registration Form
To apply for membership of Swing Out Loud please complete all questions.
Name
First Name
Last Name
Date of Birth
-
Month
-
Day
Year
Date Picker Icon
Address
Street Address
Straat en huisnummer 2e regel
City
Staat / Provincie
Postal / Zip Code
Phone Number
-
Country Code
Phone Number
E-mail
Confirmation Email
Gender
Male
Female
Status
Student
Other*
Signs up for
Quarter year Lindy Hop Lessons (€65 / €40*)
Half a year of Lindy Hop Lessons (for €90 / €65*)
Full year Lindy Hop Lessons (for €155 / €90*)
Non Lesson Lindy Hop (for €50 / €35*)
Payment Information
Bank transfer*
Cash
How did you learn about Swing Out Loud?
Online/Facebook
From a friend
From a poster
At the UT Kick-in
Other
Submit
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