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About
Instructors
Reviews
Outreach
Media
Boutique
Programs
All Programs
Youth Programs
Dynasty Stars
New Student Offer
Parkinsons Program
Latest News
Locations
Sarasota
Lakewood Ranch
Venice
Calendar
SRQ Calendar
LWR Calendar
Venice Calendar
Contact
General Questions/Inquiries
First Lesson Form
Downtown Sarasota
941.955.8558
Lakewood Ranch
941.907.8183
General Interest/Questions
Full Name
*
Please type your full name.
E-mail
*
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Phone
*
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I would like to schedule an introductory lesson at:
Downtown Sarasota
Lakewood Ranch
Venice
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Message/Question
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Submit
First Lesson Form
If you have scheduled your first lesson,
please complete the following form.
Primary Contact Name
*
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Primary Contact Email
*
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Primary Contact Phone
*
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What is the location of your first lesson?
*
[Choose One]
Downtown Sarasota
Lakewood Ranch
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What is date and time of your first lesson?
*
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If you know who your instructor is, please select
[Choose One]
Sarah
Maks
Bella
Chuck
Evie
Colton
Madyson
Vova
Sasha
Chanel
Michele
Meridith
Kiersten
Iya
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Gentleman's Info
Gentleman's Name
Please type your full name.
Gentleman's Home Phone
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Gentleman's Work phone
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Gentleman's Mobile Phone
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Gentleman's Email
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Gentleman's Birthday (mm/dd)
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I am
Under 21
21 Years or Over
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Lady's Info
Lady's Name
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Lady's Home Phone
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Lady's Work Phone
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Lady's Mobile Phone
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Lady's Email
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Lady's Birthday (mm/dd)
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I am
Under 21
21 Years or Over
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Address
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City
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State
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Zip
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Anniversary (mm/dd)
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Preferred method for confirmation of lesson
Phone
Email
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May we send e-mails of upcoming events?
Yes
No
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How did you hear about us?
I won a lesson at an event
In the yellow pages
I found you online
I received a postcard
I saw your sign
A friend referred me
I saw you newspaper ad
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I was referred by:
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Have you ever had lessons before?
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If yes, where and for how long?
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Are you preparing for a particular event?
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Date of event
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Additional Comments
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What are your area(s) of interest?
Smooth
Standard
Rhythm
Latin
Tango
Salsa
Swing/Jive
Merengue
Cha Cha
Waltz
Samba
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Types of activities in which you would like to be involved?
Social Dance Lessons
Weekly Social Parties
Competitions
Dinner Dances
Weekend Getaways
Weekly Social Parties
Vacations w/ Dance Shows
Local Events
Dance Shows
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Where do you envision yourself enjoying Ballroom Dancing?
Night Clubs
Competitions
Live Music Venues
Cocktail Lounges
Weddings
Formal Events
Restaurants
Other
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What interests you most about taking dance lessons?
Fun/Excitement
Stress Relief
Social Interaction
Exercise
New Interest
Creative Outlet
Personal Development
Improvement in Health
Enhanced Confidence
Glamour
Shared Hobby
Other
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I understand that dance can result in injuries, including but not limited to falls, bruises, or broken bones. I agree not to sue, file lawsuit, or attempt to hold Dynasty Dance Clubs liable for any injuries that may be sustained on the Introductory Lesson, and that I shall be liable for all legal costs incurred by Dynasty Dance Clubs.
*
Yes
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Submit
SRQ
2272 Main Street
Sarasota, FL 34237
941.955.8558
Directions
Venice
415 Commercial Court
Venice, FL 34292
941.955.8558
Directions
LWR
7313 International Pl
Sarasota, FL 34240
941.907.8183
Directions
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