Registration Form

Please print this form, complete and mail to:

Ballroom Break
100A Catherine Court
Lewisberry, PA 17339

Name:
Address:
City/State: Zip:
Phone # (home) Class:
Phone # (work) Fee:
*All classes $11.00 per person/class with punch card.
Drop-in Fee $15.00 per person.
Make checks payable to: Ballroom Break.
Please pre-register for all classes at least 7 days in advance.
**Cost of Classes through recreation programs may vary.