Please fill out and submit this

Online Dancer Registration Form

Please fill out and submit this form. One form per dancer registering. The price for each dancer is $24/month. Classes are held every Wednesday evening at 5:45 - 6:30 pm. Our classes are held at 2719 West Division Street. 27th Avenue and Division Street. We are in the same office complex as Fast Signs and the Military Recruitment Offices. It is right next to Panera Bread.
Please wear comfortable cloths and shoes. For any additional information please call Jessie at 320-255-1920.

Thank You and Happy Clogging

Full Name of Dancer:
Name of Parent/Guardian if under 18
Age:
Email Address:
Phone Number
Address
City, St Zip
Have you been an any style of dance classes before?	Yes No
Tell us a little about how you heard about us.