Dance Reg Form - St. Louis Ballroom Dancers

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

Choose Your Skill Level *

Novice

Skilled

Dance Classes

Choose any Novice Classes that you would like to register for *

Thursday 7-8PM - Introductory Social Dance FOX TROT • CHA CHA

Thursday 8-9PM - Intermediate Social Dance WALTZ • RUMBA

Thursday 9-10PM Pre-Silver TANGO • BOLERO

Do you need a partner to be provided for you? *

Yes

No

NOTE: For the 9:00PM class, partners are REQUIRED.
If you do not have a partner already, please stop registering and EMAIL:
partnerrequest@stlouisballroomdancers.com to make arrangements prior to registering.

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

*NOTE: Each Dancer still must be registered independently

Choose any Skilled Classes that you would like to register for *

Tuesday 7-8PM - Silver American WALTZ • NIGHT CLUB 2 STEP

Tuesday 8-9PM - International Silver FOX TROT • JIVE

Friday 7-8PM - Gold American VIENNESE WALTZ • BOLERO

Friday 8-9PM - Open International FOX TROT • SAMBA

NOTE: For the Skilled classes, partners are REQUIRED.
If you do not have a partner already, please stop registering and EMAIL:
partnerrequest@stlouisballroomdancers.com to make arrangements prior to registering.

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

*NOTE: Each Dancer still must be registered independently

Payment Details

Total Amount *

Choose Payment Method *

Credit/Debit Card via Paypal

PayPal

Check via Mail

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 the registration information on this page and click here Registration 2020 February - April to print the form. Please fill the out the form and mail with your check payable to: St. Louis Ballroom Dancers.
Mail to: Dee Townsend, 30 Topping Ln, St. Louis, MO 63131