Dancing With Local Stars

Registration Form

Thank you for your interest in attending Cornerstone's Dancing with Local Stars.

Click here if you are a dancer and need to register


Join us February 3, 2017

  • 6:00 p.m. Social
  • 7:00 p.m. Dinner
  • 7:15 p.m. - Humanitarian Award Winner Announced
  • 8:00 p.m. - Dancing with Local Stars Event
The Ambiance
5225 Kochs Lane


Please fill out the form below to register. You'll make your payment on PayPal's website. You do not need an account with PayPal, just your credit card. For table purchases, you must know all eight attendees at time of purchase.


What type of registration are you completing?

A single registration for myself or someone else
I want to register multiple people
I want to purchase a table of 8
I want to purchase a sponsorship

Single Attendee Registration

Multiple Attendee Registration

Attendee #1

+ Add another attendee

Table of 8 Registration

Attendee #1

Attendee #2

Attendee #3

Attendee #4

Attendee #5

Attendee #6

Attendee #7

Attendee #8

Please click "Submit" below only when you are ready to complete your registration.

When you click Submit, you will be redirected to Paypal to complete the purchase of your registration.

If you experience trouble with this form, please contact us at (217) 222-8254.