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Night Club Lesson

Sam & Denise Miller

April 30 & May 1, 2016

Please submit a separate form for each Student under 18. Partners are not required.

Student Name(s):
Address:
City:
State:
Zip:
E-mail:
Daytime Phone:
Evening Phone:
Guardian Name & Contact:

(Required for Students under 18)
# Dancers   Amount
Saturday, 2:00 pm   West Coast Swing, Part 1
- $28/person ($36 after Apr 26)
$
Saturday, 3:45 pm   West Coast Swing, Part 2
- $20/person ($26 after Apr 26)
$
Sunday, 2:00 pm   Night Club 2-Step
- $28/person ($36 after Apr 26)
$
The Big Deal...
- Attend all 3 of the Workshops and get FREE admission to the Country Two-Step Workshop and Dance Party, Saturday night at 8:00 pm (A value of $15). No registration required for the Country Two-Step Lesson and Dance Party.
   
  TOTAL $
   
I am interested in taking semi-private lessons in the following style(s):
I am interested in taking private lessons.
   
  Registration Fees will be due at the door.
(To save time on the day of the workshop, fees can be paid in advance at the studio.)
Thank you for registering!
 
     
540-382-8782 - info@sapphiredance.com