Novice Registration

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CLASS COORDINATOR: KEVIN BELT – 314-229-8238

ENTRANCE TO THE GYM WHERE CLASSES ARE HELD AT 300 N. NEW BALLAS ROAD IS IN THE REAR OF THE BUILDING.

Membership Year*

Class Session 1*

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

Dance Classes

Choose any classes that you would like to register for:

Member Classes–Session 1*

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

Thursday 8-9 pm – Intermediate Social Dance Foxtrot, Cha cha & Salsa

Thursday 9-10 pm Pre-Silver Waltz & Triple Swing

Non Member Pricing*

Price:

Non-Member Classes–Session 1*

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

Thursday 8-9 pm Intermediate Social Dance Foxtrot, Cha cha & Salsa

Thursday 9-10 pm Pre-Silver Waltz & Triple Swing

Member Pricing*

Price:

Member Pricing*

Price:

Dancer Information

Dancer Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Email*

Home Phone*

Mobile

Choose Your Skill Level*

Partner Information

Do you need a partner for the 7PM class?

Do you need a partner for the 8PM class?

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

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

First Last

*NOTE: Each Dancer still must be registered independently

Payment Information

Your Total

Choose Payment Method*

Online (PayPal or Credit Card)

Mail In Check

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.

Please submit this form and mail your check
payable to: St. Louis Ballroom Dancers

Mail to:
Kevin Belt, 734 Wachtel Ave., St. Louis, MO 63125

Phone

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