DUVALSTARZ REGISTRATION FORM

STARZ IN MOTION: Cheer, Dance, & Stunts

Teen Grant Program for Ages 12-18 only Thank you for expressing interest in the Starz In Motion program, presented by Duval Starz Cheer & Dance in collaboration with The Performers Academy: Creative Genius School Program. We are thrilled to invite your teens (ages 12-18) to participate in this exciting and free program, starting tomorrow, January 21 to June 8, 2025 Program Details: Tuesday, Wednesday, and Thursday Time: 4:00 PM – 8:00 PM (Students may arrive as early as 3:00 PM for homework help; all participants must be “signed in” by 4:30 PM.) Location: 3674 Beach Blvd, Jacksonville, FL 32207 Program Overview: 4:00PM – 6:00 PM: Exposure to various arts disciplines, such as: Hip Hop, Contemporary, and Modern Dance Art, Fashion, & Costume Design Music, Poetry, and Film Studies 6:00 PM – 8:00 PM: Duval Starz Cheer, Dance, Stunts, Acro, Tumbling, and Motion practices. Participants will have the chance to perform in showcases and compete in cheer and dance competitions. Please note that competitive performance opportunities will require the purchase of uniforms, costumes, and a seasonal membership fee. Registration Details: Participation in the program is FREE, but registration IS REQUIRED BELOW & Creative Genius Program Registration: https://form.jotform.com/jaxtpa/creativegeniusJAN25
Registration Information
Participant Name*

First NameLast Name
Parent Name*

First NameLast Name
Student Date of Birth*

MonthDayYear
School Name
Parent E-mail*
Primary Phone*

Area CodePhone Number
Cell Phone*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Emergency Contact Name*
Relationship to Participant*
Emergency Ph*

Area CodePhone Number
ASAMALAXLA2XL
Parent - Are you interested in volunteering with Duval Starz?
Notes/Questions/Concerns::
Disclosure

By submitting this registration form, I acknowledge that:

My student will participate in the Starz In Motion Program three days per week (Tuesday, Wednesday, and Thursday) from January 21st to June 8, 2025.
Any absences must be excused by the Duval Starz Director, Dana Parrish, prior to the missed session.
My student is expected to demonstrate good behavior and adhere to program rules at all times.
My student must attend each practice in the required uniform or a Duval Starz Cheer & Dance T-shirt to ensure readiness and team cohesion.
I understand that failure to comply with these expectations may result in my student’s participation in the program being reassessed.
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STARZ IN MOTION: Cheer, Dance, & Stunts

Registration Information