Belly Dance Classes

"Maya's Belly Dancing"

Participant Registration Form

(please note: there are no refunds once your class has started)

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address *

Which class(es) are you signing up for? Please choose the ones you will be attending: *

Please specify your class start date (MM/DD/YYYY). This marks the beginning of your monthly membership and secures your place in the class. If you're opting for a single session, please specify the date you plan to attend. Note that by selecting your class dates, you're reserving your spot, and as such, we are unable to offer refunds. Let's ensure a smooth and joyful dance journey together! * +

Would you like to receive our monthly newsletter? *

Yes

No

Please indicate any major health issue your instructor needs to know

In Case of emergency, please call (NAME AND NUMBER):

How did you find out about Maya's Belly Dancing? *

Please check the packages you are registering for bellow: *

Coupon Code

Maya's Monthly Package Agreement

"By checking this box and submitting this form, I acknowledge that I have read and agree to abide by the Terms and Conditions outlined above in the Monthly Class Package Membership Agreement (if I'm signing up for the monthly classes)." *

I acknowledge that I have read and agree to abide by the Terms and Conditions outlined in the Monthly Class Package Membership Agreement and/or Refund Policy for both monthly classes or single classes.

By signing here, you acknowledge that you have read, understood, and agreed to the terms that apply to your membership when joining Maya's Belly Dancing classes. *

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