Registration Form

Please fill out the following information to register. No payment is required to register.

Name:

Phone:

Email:

Individual
Couple
Child

Please specify lesson type:



Start Date:

Type of dance:




Cha Cha Cha


(Footwork)

Level:
Beginner Level 1
Beginner Level 2
Beginner Level 3
Intermediate
Advanced

Please select a LOCATION:

Etobicoke Location (118 Seventh St.)
  
Mississauga Location (Oplenac - 895 Rangeview Rd.)
  
Other Location (One time workshops, etc.)
  

 
How did you hear about us?

 

 

Referral:

student
friend
word of mouth

Add:

Newspaper
Flyer

 

Search Engine:

Goggle
Yahoo
Msn
Other

Please specify:

Internet:

www.facebook.com
www.latinenergy.ca
www.salsato.ca
www.tosalsa.com
www.torontodancelessons.com
www.yellow.ca
www.redtoronto.com
other site, please specify:
Other, please specify:

Comments:

 

 
© 2010, Latin Energy Dance Company. All rights reserved.
416.876.7727