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Private Class Request Form

First Name

Email

Last Name

Phone Number

Requested Date

Time

Alt. Time

# of Participants

Other: Pleae Specify

What is the occasion?

Qaurentine fun!

Birthday

Bridal Party

Duration

1 Hour

1.5 Hours

2 Hours

What type of class were you interested in?

Striptease

Conditioning

Chair Dancing

.

Twerk

Flexibility

Paint/Craft

Are all of your guest female, AND above 18 years of age?

Yes

No

Thanks for submitting! We will be in contact with you within 48 Hours

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All donations are to be made to via PAYPAL

or with any major credit card through our secure

Note: New Paypal regisrtation may take
24-48 hours and may delay your appointment request.