Silver Registration

Membership Year(Required)

Class Session 5(Required)

Is anyone in your household a member for the current year?(Required)

Dance Classes

Choose any classes that you would like to register for:

Member Classes--Session 5(Required)

Tuesday 7-8 pm - Silver American Foxtrot & Cha Cha

Tuesday 8-9 pm - Silver International Waltz & Jive

Member

Non-Member Classes--Session 5(Required)

Tuesday 7-8 pm - Silver American Foxtrot & Cha Cha

Tuesday 8-9 pm - Silver International Waltz & Jive

Non

Dancer Information

Dancer Name(Required)

First Last

Address(Required)

Street Address Address Line 2 City State ZIP Code

Email(Required)

Home Phone(Required)

Mobile

Choose Your Skill Level(Required)

YOU MUST PROVIDE YOUR OWN PARTNER FOR THE TUESDAY CLASSES.

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

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:
Lynna Overby,
666 Oakland Avenue,
St. Louis MO 63119