All Star DANCE Interest Form

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Please fill out the information below to the best of your ability! We are so EXCITED you are interested in being a part of Tupelo's Premier Cheerleading & Dance Gym! If you have any questions, please feel free to email, text or call us at jace@southernheatallstars or 662-610-7427

If you have multiple athletes interested, please fill out a separate form for each.

Parent Name (first & last) *

Athlete Name (first & last) *

Athlete Birthdate *

YYYY

Athlete Age *

Current School *

Parent Email *

Parent Phone *

Any prior Dance Experience? *

YES

Any School Dance Team Experience? *

YES

Where have you had prior experience and what teams? *

Dance Style Interest *

Hip Hop

Pom

Both

Unsure

How did you hear about Southern Heat?

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