Parent Contact Name *

First Name

Last Name

Student Name

First Name

Last Name

Which day(s) work for a weekly 1pm class for 6 consecutive weeks? *

Please select all that apply

Monday

Tuesday

Wednesday

Thursday

Friday

What end result would be most exciting for this student? *

Please select one

A routine they could all perform together at the end of the sessions.

Being able to dance at a formal event.

Being able to dance socially at an informal event.