Please fill in the following form and click
the "Submit" button at the bottom:
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*E-mail : |
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Class choice: |
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Please read the following: |
Discounted fee is non-refundable and is not transferable
toward subsequent sessions in the event of missed classes. However,
punch cards issued by Gypsy are non-expiring and fully transferable
if purchaser desires to sell them or bring a friend. Punch
cards issued by Gypsy may be used for any combination of classes
taught by Gypsy only. Punch cards issued by Alex and/or
Nahara may also be used for any of Gypsy's classes
Combination classes available to Beginner II, Intermediate, and Advanced students only...please inquire about specific guidelines for instructor approval. I understand that Middle Eastern Dance can be strenuous physical activity, and that I should consult my physician before beginning any new exercise program. I also understand that any and all instructors and Reynolda Village of Wake Forest University accept no liability for any injury or problems resulting from the exercises in these classes. Do you agree to the above terms? yes no |
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Status: Children: Ages: Pets: Describe: Your Birthdate: Example (mm/dd/yy) Occupation and Place of Employment: Hobbies/Special Interests: Any past dance or theater experience or training? Yes No If Yes, please describe Do you play any musical instruments? Yes No If yes, please describe Do you have any physical constraints, illnesses or past injuries? If yes, please list below. How did you hear about my class and/or web site? (Example: Friend, yellow pages, internet search, newspaper. If referred by friend please list name)
Do you have any concerns or questions? Are you interested in continuing lessons and perhaps joining a troupe? Yes No Don't know. |
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