Salsa Dance Lessons Registration Payor Name* First Last Student Name* First Last Student Age* Email* Phone*Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code For lessons please submit the day and time that works best for you. The instructor will reach out with their open availability.* Choose your lesson duration30 Minutes45 Minutes60 MinutesFALL 2023 DATES August 21- December 15, 2023 (No Lessons Thanksgiving Week, November 20-24)Payment information* I agree IMPORTANT: Payments only accepted by PayPal account. You will be automatically redirected to PayPal. Cash and checks not accepted. Total $0.00 PhoneThis field is for validation purposes and should be left unchanged.