Guest Teacher Submission Form

Name *

First Name

Last Name

Phone Number *

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of Birth *

*Must be 18 years of age or older

MM

DD

YYYY

Are you a returning guest teacher and/or DMW dancer? *

Yes

No

Dance Style(s) *

Select all style(s) you're interested in teaching

Hip Hop

Jazz

Contemporary

Lyrical

Tap

Other (we're always open to adding new styles!)

Acknowledgment of Liability Release *

I have read and agree with the above liability release

I Agree