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Trial Class Form
Please fill out this form to register for your free trial class. We'll see you on the dance floor!
* Indicates required question
Dancers Name:
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Your answer
Dancers Birthdate:
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MM
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DD
/
YYYY
Dancers Age:
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Your answer
Parent/Guardian Name:
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Your answer
Email
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Your answer
Address
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Your answer
Phone number
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Your answer
Please list two emergency contacts besides yourself, below.
Name, relationship and phone number (i.e.) Sarah Smith, Aunt (562) 555-5555.
Emergency Contact #1
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Your answer
Emergency Contact 2
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Your answer
Does your dancer have any health issues or special needs that we need to be made aware of? Please be specific and as detailed as possible.
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Your answer
Which class would you like to take as a trial? Dancers can only take classes in their age and level. Indicate below.
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Your answer
Thank you for filling out this form! You will receive a confirmation email shortly from a member of our team within 24 hours. For questions, call (562)351-6559 or email info@gravitydanceco.com.
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