CENTRE STAGE REGISTRATION

Name *

First

Last

Email *

Phone *

Stage Name if you have one

Stage multiple) Link

Link to audition video *

Videos must be between 2-3minutes long and no more than 6 months old.

Your Instagram handle

Studio you are representing (can be multiple)

Division *

Not sure about Divisions. Please check the Centre Stage Description page here https://www.elementspoleaerialfitness.com/centre-stage/ $35 per Solo $55 per Duo $75 per Group 3+

Total Amount

$0.00

Payment Method *

Card Number

Expiration Date

Security Code

Card Holder Name

Title