Trial Class Request

SYNERGY DANCE ACADEMY

Trial Class(es) Request Form

* Indicates required field

Dancer's Name *

First

Last

Dancer's Date of Birth *

Parent Contact's Name *

First

Last

Parent Contact's Email *

Parent Contact's Phone Number *

Class(es) Dancer is Interested in Trialing *

Preferred Day to Trial *

Additional Information *

I agree to receiving marketing and promotional materials

Submit

160 S Bloomingdale Road
Bloomingdale, IL 60108
(630) 893-1444