Club Information Update

If you have more than one dance location, please fill out the Required Fields of a second form for that location.

  Required Fields


Your Name:

Your Phone:

Your E-Mail:

Club Name:

Club Website - If you know it:


Dance Location Name:

Dance Location Address:

Additional Location Information If Necessary:

Dance Location City:

Dance Location State:


Caller Name(s):  (If None, leave blank, or enter "Guest")

Round Dance Cuer(s):  (If None, leave blank, or enter "Guest")

Line Dance Cuer(s):  (If None, leave blank, or enter "Guest")

Dance Time:

Dance Day:  Day of Month (Ex. 1st Friday, 3rd Wednesday):

Dance Level:  (Basic, M/S, Plus, Advance, Rounds Phase II - IV, Lines, etc. - List All That Apply):

Contact Name:

Contact Phone:

Contact E-Mail:

Alternate Contact Name:

Alternate Contact Phone:

Alternate Contact E-Mail:

Local, State, & National Federations, Associations, or Groups Your Club is Associated With:

Additional Information:

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Updated 9/28/15