All information is kept private!
Date:
Name:
Street Address:
City:
State:
Zip:
Telephone:
Email Address:
Payment Method:
None Visa Mastercard Cash Check Other
Payment Amount:
Class/Workshop:
Choose a Class/Workshop... Bands and Balls Class - 1hr Beginning Yoga - 1hr Bellylicious Belly Dance - 1hr Body Boot Camp - 1hr Cardio Hoop Class - 1hr Circus... Class - 1hr Class Sampler - 1hr Ero-Cardio Class - 1hr Ero-Dance Class - 1hr Ero-Fitness Class - 1hr Feeling Your Core-Ball Class - 1hr Gyro Pole Class - 1hr Kinky Kickboxing Class - 1hr Lap Dance Perfection Class - 1hr Pole Dance Perfection Class - 1hr Pole Fitness Class - 1hr Power Yoga Class - 1hr Stretch and Flex - 1hr Acro - 2hrs Ab & Bun Blaster Workshop - 1hr Discover Burlesque Workshop - 8hr Ero-Cirque Workshop - 8hr Intro to Erotic Dance Workshop - 2hrs Explore Erotic Dance Workshop - 4hrs Emersion in Erotic Dance Workshop - 8hrs Floor Fitness #1 - 2hr Go Go Dance Workshop - 1hr Intro to Gyro Pole - 2hrs Hoop Dance - 2hr Lap Dance Techniques Workshop - 2hrs Intro to Pole Dance Workshop - 2hrs Pole Dance #1 Workshop - 2hrs Pole Dance #2 Workshop - 2hrs Pole Dance #3 Workshop - 2hrs Pole Dance #4 Workshop - 2hrs Intro to Pole Fitness Workshop - 2hr Pole Fitness #1 Workshop - 2hrs Pole Fitness #2 Workshop - 2hrs Pole Fitness #3 Workshop - 2hrs Pole Fitness #4 Workshop - 2hrs Whole Body Workout Workshop - 4hrs Specialty Workshop Private Party Other
If needed please explain:
Date of Class/Workshop:
Time of Class/Workshop:
How did you hear about us?
I, (your name) , have read and accept all LeeLynn Studios policies.
Questions / Comments: