Dancer Name *

First Name

Last Name

Parent Name*

First Name

Last Name

Items *

Picture and payment must be submitted no later than Friday, May 10th.

1/4 Page Parent Message NO photo $40

1/4 Page Parent Message WITH PHOTO $45

1/2 Page Parent Message NO photo $60

1/2 Page Parent Message WITH PHOTO $65

Full Page Parent Message NO photo $85

Full Page Parent Message WITH PHOTO $90

Form of Payment *

Payment must be received by Friday, May 10th. Make payment payable to Aspire Dance Academy.

Cash

Check

Online (make a one-time payment for order total https://securepayment.link/aspiretodance/ )

PARENT CONTACT INFORMATION *

First Name

Last Name

Cell Phone *

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