Register for Classes


Student Name:

Address:      
City:       Postal Code:

Home Phone:       Cell Phone:      
Email:


Please specify any medical conditions:


In Case of Emergency contact:     
Home Phone:      Work Phone:



Please select the class(es) you are registering for:

Beginner / Level I Belly Dance - Thursday 6:00 - 7:00 ($160)
Level II/III Belly Dance - Thursday 7:00 - 8:30 ($175)



Payment Options: )

OR will pay by cash or cheque in person at my first class  

              
  If you would prefer to pay with Paypal, click  
Click SEND to complete your Registration! >>>
Fall Class Times:

   
    BEGINNER Thursday
    6:00 - 7:00
    LEVEL II/III Thursday
    7:00 - 8:30



Conditions:
    - Withdrawal will only be accepted within the first three (3) weeks of each term, and will result in a $20 withdrawal charge. No refunds or credits will be given after this point.
   - Classes subject to sufficient enrollment.