TIPDI - WCS Intensive Class Registration

Registration Form
$5 Intro to West Coast Swing!
Monday September 10, 2018
7:30-8:30 pm
Instructors: Paula Wilson & Ken Kreshtool

* Indicates required field

Name *

First

Last

Email *

Primary Phone # *

Mailing Address *

How Did You Hear About Us? *

I am registering for: *

$5 Intro to West Coast Swing!

I am registering as a: *

Leader Follower Either one as needed

I am registering *

Solo With a partner

If with a partner, please list their name here: *

Do you have any prior dance experience? If so, please describe. *

Do you have any injuries or physical limitations of which the instructors should be aware? *

I understand that I am enrolling in a program that requires rigorous physical activity. I certify that I am 18 years of age or older, and that I am physically able to handle the activity. I understand that neither TIPDI, its instructors, or staff, are liable in the event of any injuries I may incur. (Please check below.) *

I understand and comply with the above statement.

When you click the "CONTINUE" button, your Registration form will be emailed to us, and you will be taken immediately to our Thank You page — which lists the exact address for this class! Write it down (or screenshot it)! It appears nowhere else! Thank you!

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Registration Form$5 Intro to West Coast Swing!Monday September 10, 20187:30-8:30 pmInstructors: Paula Wilson & Ken Kreshtool

Registration Form
$5 Intro to West Coast Swing!
Monday September 10, 2018
7:30-8:30 pm
Instructors: Paula Wilson & Ken Kreshtool