Class Registration Form

Please fill out the registration form completely and as accurately as possible.

Gender:    Male      Female

Reason(s) For Taking Class (Check all that apply)
Basic knowledge (understanding basic moves)
Exercise (weight management, weight loss, strengthening)
Social dancing (ability to lead/follow)
Competition level (ability to use technical skills to enter competitions)
Other (please specify)

Additional Information:
Dance Experience:    Yes      No

Please check other classes of interest to obtain additional information:
Mondays - "Beginner I/ Intermediate/Advanced" with Kevin Fitzhugh and Tammy Brown
Wednesdays - "Beginner II/ Intermediate/Advanced" with Tammy Brown
Thursdays - "Beginner I" with Tammy Brown
Private Lessons with Tammy Brown
Private Lessons with Kevin Fitzhugh

By submitting this form, I agree that all information entered was done accurately & truthfully and that I may be contacted by a Swing Fusion representative to confirm my registration.
I agree:

Contact Information

Tammy Brown

Cellphone: 443.271.9250

Kevin Fitzhugh

Telephone: 301.439.0748
Cellphone: 240.381.6324