Registration / Trial lesson request

  1. DIT IS EEN TESTVERSIE!
    FORMULIER NIET GEBRUIKEN!


    Registering through this form does NOT include any payments.

    You will receive a confirmation and authorisation form send by e-mail. Please complete this form and deliver it to the desk before your third lesson (2nd regular lesson). This authorisation form can also be obtained from the counter at Step by Step Dance School.

  2. Name new member(*)
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  3. Gender(*)
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  4. Subscribed by ( optional): (e.g. name of parents)
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  5. Address(*)
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  6. ZIP Code(*)
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  7. City(*)
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  8. Date of birth(*)
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    dd-mm-yyyy
    dd-mm-yyyy
  9. Phone number
  10. Mobile phone number 1
  11. Mobile phone number 2
  12. E-mail address(*)
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  13. E-mail dancer ( if not the same )
    Onjuiste gegevens
  14. I know Step by Step














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  15. Other
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  16. Date of free introduction class
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    dd-mm-yyyy
    dd-mm-yyyy
  17. Register
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  18. Wants to go dancing in:
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  19. I'm interested in

















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  20. Other remarks
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  21. Security code
    Security code
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  22. Send form