Membership Registration Form - St. Louis Ballroom Dancers

Membership Form St. Louis Ballroom Dancers

If you are human, leave this field blank.

Dancer Information

First Name *

Last Name *

Select Number of Dancers *

Additional Dancer First Name

Additional Dancer 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

We Announce Member Anniversaries and Birthdays in our Newsletter

Enter your Anniversary and Birthday if you would like to be recognized in our Newsletter. (optional)

Anniversary Date

Your Birthdate

Additional Dancer Birthdate

Payment Details

Total Amount *

Choose Payment Method *

Credit/Debit Card via Paypal

PayPal

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

On the following payment screen, just click the link as shown highlighted in the picture below with the red arrow.
Note - you will need to click on the 'Submit' button below to get to the above mentioned screen and proceed as instructed above.