Swing Dance Class Registration Form

To register for a class series: print this form, fill it out, and mail it with your payment no later than the Friday before classes start to:

Savoy Swing Club Classes
P.O. Box 12114
Seattle, WA 98102

      Name(s):_________________________________________________________

      Phone:_______________________________  Member? __________________

      Address:_________________________________________________________

      City/State/Zip:__________________________________________________

      Email:___________________________________________________________

    Check this box if you prefer email rather than postal mail about new classes and workshops.

     Please write in information and check the boxes next to classes you 
     wish to take. To save writing, you can sign up online.

Class session________________________________ Year____________________

Day	Class Name	Starts (date, time)	Role
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________________	________________	________________	Lead	Follow
________________	________________	________________	Lead	Follow
________________	________________	________________	Lead	Follow
________________	________________	________________	Lead	Follow

         Each 5-week class series is: $40 for current members, $55 non-members ($5 more at the door)
         Each 4-week class series is: $35 for current members, $50 non-members ($5 more at the door)

           If you've taken an Intro or Essentials-level class before, you may retake it for $30 ($5 more at the door)
           Cash Check #____________ Total amount due: $______________

         In signing below, I agree to dance in a safe and responsible manner so that I do not endanger myself or
         others. I also agree not to hold the instructors, the Savoy Swing Club, or the class locations responsible
         for any injuries or damages sustained by me during class or practice sessions.

         Signed ____________________________________________ Date _____________

         2nd Signature _____________________________________ Date _____________