Groove Juice Swing Registration

Registration for:
Jazz Up Your Lindy Hop II
Starting Tuesday, April 20, 2010

First Name:

Last Name:

Street Address:

City:

State:

Zip:

Telephone:

Email:

Role:Leader Follower

Please enclose $40 in the form of a check, payable to Groove Juice Swing.

Rochester classes: Mail to 315 E. Henrietta Rd., Rochester, NY 14620

Ithaca classes: Mail to 340 S. Geneva St., Ithaca, NY 14850