Home Phone: (_____)____________
HERS: Work Phone: (_____)_____________Cell Phone: (_____)____________
E-mail: __________________________
HIS: Work Phone: (_____)___________Cell Phone: (_____)___________
E-mail: __________________________
How did you learn about Two Left Feet?
_________________________________________________________
GROUP CLASS DAY
Circle:
- MON - TUES - WED - THURS - FRI - SAT -
TIME:_______ START DATE:___/___/_____ DANCES:______________________________________
FEE: Senior or Day $72/person for 6 classes _____
12 Evening Group Classes: Adult Single $265 _____ Adult Couple $395 _____
6 Sampler Group Classes:
Adult Single $140 _____ Adult Couple $220_____
PRIVATE LESSONS
Circle: - 1 - 3 - 6 - 12 - 24 - 48 -
Circle: DAY or EVENING
FEE: $__________
To receive quantity rated discount, fee must be paid in full.
PRIVATE PARTY
Date: ______/______/______ Time: ________
1 hour = $270 (for two instructors)