First Name Last Name Mailing Address City State Zip Code Home Phone Number Cell Phone Number Age Date of Birth MM/DD/YYYY T-Shirt Size Choose One... S (Youth) M (Youth) L (Youth) S (Adult) M (Adult) L (Adult) Grade Level (Next Fall) School Attending (Next Fall)
Name (s) Home Phone Number Cell Phone Number Work Phone Number Email Address
Name Relationship Phone Number Alt. Phone Number
Will the participant attend ALL rehearsals (for the full length of time) & ALL performances? Choose One... Yes No If no, please explain:
Registration/Membership Fee: $175.00 Payment Type: Credit Card Check On Site
Full Name Billing Address City State Zip Code Card Type Choose One... VISA MasterCard Name on Card Card Number Expiration Date MM/YYYY CVV Code
Please make checks payable and mail to: Arizona Academy of the Performing Arts ATTN: Summer Youth Guard P.O. Box 11926 Tempe, AZ 85284-0033
Please bring a check for the $175 membership fee to the first rehearsal.
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