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Ballroom Dance Club Profile
Club Profiles will be used for 'Members' & 'Guests(Non-Members)
1) Please complete your Profile
'before'
making any Club payment(s)
2) If you Do Not plan to attend any BD Club activities this year, please disregard
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* Indicates required question
NAME(s):
Enter Last Name first:
Last Name, First Name(s)
*
Your answer
EMAIL(s):
Enter both emails (if applicable)
*
Your answer
PHONE:
(Optional)
Your answer
Attend Any 2024 Club Dances?
*
YES
NO
UNDECIDED
'TABLE LOCATION' @ Dances:
Proximity to Stage / Ballroom
*
FRONT (Nearest the Stage)
MIDDLE (Center of Ballroom)
REAR (Farthest from Stage)
NO PREFERENCE
N/A (Not Attending Any Club Dance)
Other:
Sit @ Same Table with others @ Dance?
Enter
Last
Name,
First
Name(s)
Table of '8 Maximum'
If No Preference - leave blank
Your answer
DINNER ENTREE Preference
Select Only
One
'Other': Enter 2 different ones for a Couple
*
BEEF
CHICKEN
FISH
VEGETARIAN
NO PREFERENCE
Other:
Take any Club Dance Lessons?
Select all that Apply
'Other': Dance Type I want to Learn
*
YES
NO
UNDECIDED
If Yes: Pay in Advance with Debit/Credit Card
If Yes: Pay in Person with Cash/Check
Other:
Required
Plan to Join the Club?
Registration Open: Jan. 1 - Feb. 29
*
YES
NO
UNDECIDED
Plan to Attend January 26 Dance?
*
YES
NO
UNDECIDED
Pay to 'Join Club'
or
'Attend Jan. 26 Dance'?
Cash
/
Check
@ "Eagles Nest
" (2 dates)
Debit /
Credit Card
(Secure-Link to Email)
Jan. 26 Dance:
Free w/Paid Membership
)
*
Pay @ Eagles Nest: Jan. 9 (9am-11am)
Pay @ Eagles Nest: Jan. 11 (9am-11am)
Email Link to Pay w/Debit or Credit Card
Pay on Website with Debit or Credit Card
N/A - Not Joining Club or Attending Dances
Other:
QUESTIONS OR COMMENTS?
Your answer
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