Please complete the information sheet below to join a class at Dance Nirvana. Name * Please enter your full name First Name Last Name Phone * Please select your country code and enter your contact number; preferably WhatsApp. Country (###) ### #### Email * Your interests * Please check all that applies Yoga with Somatics (Interdisciplinary) Contemporary dance techniques & choreography Dance fusion fitness Mindfulness with movement Gymnastics & Pilates Individual Classes Dance Projects Studio rentals Other(s) Address Please enter your mailing/physical address Message Let us know about yourself or if you have any queries, concerns, or need of a special support Emergency Contact Name First Name Last Name Emergency Contact Phone Country (###) ### ####
