USA DANCE CHAPTER 1025 PRESENTS FALL CLASS REGISTRATION

FOXTROT MONDAYS January 10 – Feb 7, 2011 6 PM – 7 PM

Instructor: Christine Luders

Location: Bremerton Masonic Temple 878 5^th Ave, Bremerton

Early registration highly recommended

Fill out and mail the registration form below to reserve your spot in class.

Still have questions? Call Sheila at 662-8924

Every Monday for FIVE weeks starting Oct 25 – Nov22, 2010

Fees:

General Public: $50.00 per person for the 5 week class series

USA DANCE Member: $40.00 per person for the 5 week class series

Drop in Fee is $12.00 per hour.

Name:					Date:
Name:
Mailing Address:		City:	State:		Zip Code:
Home Phone:		E-Mail Address:
Work Phone:
Member of USA Dance? Y_____ N ______		Membership Number:
Foxtrot	6:00 – 7:00 PM Mondays January10-Feb7. 2011			$
CHECK TOTAL: Pay to: USA Dance Kitsap Mail to: USA Dance Kitsap PO Box 3617 Silverdale, WA 98383				TOTAL $