The Alaska Club Dance Classes

Register below!

Registration Form
Check spelling and fill out completely. *These fields are required.

*Participant Name

Emergency Contact

Emergency Number

*Participant Mailing Address

*Phone

*Email

Work Phone

*Date *Member/Scan Number

Charge

	You have my approval to charge the cost of the Zumbathon to my account for this.

For more information, contact JT Timothy at 330-0150 or jtimothy@thealaskaclub.com.

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