The following form should be completed by Academy Members
planning to participate in the Academy World Tour to Hawaii.
Student Information:
School Name :
Director Name :
Student Name :
Student Address:
Student City:
Student State:
Student ZIP Code:
Student Home Phone Number:
Student Cell Phone Number:
Birthdate:
Email Address :
Camp where you
made Academy:
Check all that apply:
Kick Academy
Dance Academy
T-Shirt Size :
Sweatshirt Size :
Leotard Size :
Shoe Size :
Dance Pant Size :
Parent Information:
Mom's Name:
Mom's work or cell phone:
Dad's Name :
Dad's work or cell phone:
Please enter any other comments which you may have:
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