Name:

Address:

City/State:

Zip:

Phone # (home)

Class:

Phone # (work)

Fee:

*All classes $11.00 per person/class with punch card.
Drop-in Fee $15.00 per person.
Make checks payable to: Ballroom Break.
Please pre-register for all classes at least 7 days in advance.
**Cost of Classes through recreation programs may vary.