Chi-Town Squares

Mainstream DBD Registration

You'll be directed to PayPal to complete your registration after filling out this form and hitting the Submit button.

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email Address

Phone

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Emergency Contact Name

Emergency Contact Phone Numner

(###)

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Club Affiliation

Saturday Lunch, please choose one

Let us know of any Food Allergies and other things we should know

Chi-Town Squares is Chicago's LGBTQ* Modern Square Dance Club