New Student Registration Form

First Name *

Last Name *

Email *

Phone number *

Is it your first time registering? *

Yes

No

What sessions do you plan on participating in? *

Monthly Membership

In-Person Drop-In

Online Drop-in

Other (Please give details below)

Please check the boxes below before participating in any activities at Dalida Bellydance School *

I hereby release Dalida and all related parties from any claims for loss, damage, or injury

Photos & videos of me can be used in any marketing purposes

Required

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