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Beshkan Dance Academy

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Phone *

Email Address *

Date of Birth *

Street Address *

Apartment, suite, etc

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Classes *Kids Classes (Ages 3 to 12 years)Youth Classes (Ages 13+)Adult Fitness (South Bay - Los Gatos)Adult Fitness (North Bay - Los Altos)Private LessonsWedding Private LessonsPlease select the class or classes you are interested in.

Emergency ContactMust provide an emergency contact

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First Name 1

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Phone 1

First Name 2

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Phone 2

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Photo/Video Release WaiverPlease sign our photo/ video waiver below. If under 18 parent/ guardian name & consent is required

Student's First Name *

Student's Last Name *

Parent/ Guardians First Name *

Parent/ Guardians Last Name *

Today's Date *

Dance

Poetry in Motion

Beshkan Dance Academy

contact info

(408) 378-3234

Dance Boulevard

1824 Hillsdale Ave, San Jose, CA 95124

Fitness Classes are held at various Bay Area locations. Contact us for details.