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Salsa Course Registration

Enrollments accepted until course fills (1st come, 1st served in order of payment dates).
  1. Submit this Salsa Registration Form below, clicking to choose payment option.
  2. When payment in full is received, your place will be confirmed with an email receipt.
Salsa Registration Form
Full name
 Ms.  Mr.  First  Last
Email address
Phone number
Day  Night
Postal code

                  (click one)
I first found out about Susana
Domingues Dance School through:
Word of Mouth
Google Search listing
Yahoo Search result
                         (click) Register me for Beginner Salsa:
10 Wed's 7:00-8:25 pm, Jan.3 - Mar.7/18

    (must click this box) I agree to the following:
      * No refunds, credits or deferrals for withdrawals or
        missed classes.
      * Course enrollments are non-transferable.
      * I release Susana Domingues of any claims and
         I will sign a waiver as such.
      * Everyone, no exceptions, switches partners at class.
                  (click one) Payment Method:
please charge the fee on Nov.30 to the same
        credit card used for my last course
I will eTransfer the funds to Susana Domingues
I will call with credit card payment
NO EMAIL ADDRESS?   Print and complete this form. Sign beside "Submit Registration". Send to postal address above.

QUESTIONS?   refer to FAQ page or email: