Ft Myers, FL Dance Camp March 13-14-15, 2026

Attendee Name^*

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Do you have

Lower Back Pain Osteoarthritis Arthritis Diabetes

Take medication for

Depression High Blood Pressure High Cholesterol Diabetes

Have you had

Hip Replacement Back Surgery Knee Replacement Heart Surgery

How many years have you line danced?

Are you an Instructor?

If not, who is your Instructor and where do you line dance?