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Names:________________________________________________________________________

Summer:________________________________________________________________________

                                                Street                                                                           City                                   State/Zip

Winter: ________________________________________________________________________

                                                Street                                                                            City                                     State/Zip

Phone:_______________________________

Email: ________________________________    

Have you previously been a LDC Member?   Y / N 

Would you participate in Dance Lessons?  Y / N

Type of Dance lessons preferred.   Swing/ Foxtrot/ Waltz/ ChaCha/ Polka/ Tango/ Rumba/ Country

Membership  Application for the Dance Club

Mail to:

Lakeside Dance Club

C/O NIkkl Wait

6174th Avenue NE

Glenwood, MN 56334

      To join:

• Print this page

• Complete form

1. •Make check to:
   

2. •Dance Club Membership”
   

3. •Mail form & check:
   

1. ☐$100 Couple Season Membership
   

2. ☐$150 Couple Sustaining Membership
   

3. ☐$50 Couple New Memberships
   

4. ☐$50 Couple under age 30
   

5. ☐$50 Individual Season Membership