Dance Ambassador Registration Form

Dance Ambassador Registration Form

Searching For Dancers With A Strong Dance Background Between The Ages Of 7-25 +An Additional Opportunity For Dancers Between The Ages Of 3-6 With Strong Personalities. Only Accepting A Limited Number Of Dancers To Be A Part Of This MSP Experience.
Participant's Full Name

First NameLast Name
Participant's Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Gender
Participant's Contact Number
Please enter a valid phone number.Format: (000) 000-0000.
Participant's Email Address
example@example.com
Participant's Facebook
example@example.com
Participant's Instagram
example@example.com
Participant's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Guardian's Name

First NameLast Name
Relationship to Participant
Guardian's Contact Number
Please enter a valid phone number.Format: (000) 000-0000.
Guardian Facebook
Guardian's Email Address
example@example.com
Dance Studio Name
The Dance Studio you attend
Favorite Style of Dance
Ex. Ballet, Hip Hop
Why do you want to be a MSP Dance Ambassador?
What do you like most about dance?
Email your 3 images to info@michelleskarpness.com Include your name in the email.
By submitting this form, I acknowledge that:

The information provided is accurate and complete.
I agree to abide by the rules and regulations of the dance ambassador program. I agree that my pictures can be used for social media, promotions etc.
I understand that any misrepresentation of information may result in disqualification.
Participant's Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Should be Empty: