Dance Reg Form - St. Louis Ballroom Dancers

Membership Year

Class Session

Dancer Information

First Name *

Last Name *

Address *

City *

State *

Zipcode *

Email Address *

Home Phone Number *

Mobile Number

Is anyone in your household a member for the current year? *

Yes

No

Cost per class for Non-Members

Choose Your Skill Level

Novice

Skilled

Dance Classes

Choose any Novice Classes that you would like to register for

Thursday 7-8 pm - Introductory Social Dance: Waltz, Rumba & Triple Swing

Thursday 8-9 pm - Intermediate Social Dance: Foxtrot & Cha Cha

Thursday 9-10 pm Pre-Silver: Waltz & Rumba

Do you need a partner for the 7PM class?

Yes

No

Do you need a partner for the 8PM class?

Yes

No

YOU MUST PROVIDE YOUR OWN PARTNER FOR THE 9:00 PM CLASS

First and Last name used to register your dance partner. *

*NOTE: Each Dancer still must be registered independently

Number of Classes Chosen for Members

Number of Classes Chosen for Non-Members

Payment Details

Cost for one Class for Members

Cost for two Classes for Members

Cost for one Class for Non-Members

Cost for two Classes for Non-Members

Choose Payment Method *

Credit Card via PayPal

PayPal

NOTE: If paying by credit/debit card or mailing in a check, you do not need a PayPal account to proceed.

CREDIT OR DEBIT CARD

Click on the 'Submit' button below to get to the payment type screen.
If paying by credit card or check, you do not need to fill out the PayPal information.
Continue scrolling down, past the 'Pay with PayPal' and 'Log In' button. At the bottom is the button 'Pay with Debit or Credit Card'.
Click on 'Pay with Debit or Credit Card'.
This will bring you to a page to fill out your credit or debit card information.

MAILING IN CHECK
Fill out the registration information on this page and click here Registration 2021 September - October to print the form. Please fill the out the form and mail with your check payable to: St. Louis Ballroom Dancers.
Mail to: Lynna Overby, 666 Oakland Avenue, St. Louis MO 63119