*Disclaimer: This form is to provide us contact information when registering and paying online.

By providing your contact information, you are expressing an interest in receiving free information concerning dance instruction. Any information collected on this site is purely to assist us selecting an instructor to contact you with relevant information. Any information collected by this site will not be sold to any third party for any marketing purpose.
Email Address:
           Phone Number:
First Name:
Last Name:
  Partner's First Name:
Last Name:
Address:
City:
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If you have problems using this form to register, please call us at: (417) 869-6789
or email us at: Dance@DanceWithMe.us



“If dancing were any easier it would be called football.” — Unknown



Dance With Me | 610 E. Delmar, Springfield, MO 65807 | (417) 869-6789 | Dance@DanceWithMe.us
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