Registration

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Thank you for your interest in our Award Winning Luminary Competition Team! Be sure to fill out our Audition Application at https://www.aka.dance/aka-luminaries to complete your registration. After you register, your audition fees will be added to your account. Audition fees are due June 5th! If you are a current Luminary, your audition fees will be discounted to only $10. If you are registered for our Summer Dance Intensive, your audition fee will be waived. Check out our website for more information!

Event:

Start Date/Time:

End Date/Time:

Fee per Student:

Room:

* - denotes required fields

Family Information

	First Name:*	Last Name: *
	Type*
	Home Phone:	Cell #: Work #:
	Email:*	(Emails are kept confidential)

	Address: *
	City: *	State: * Zip: *
	Emergency Contact Info (Not Contact #1 or #2)

Students entered below will be added to your family's account

Additional Information:

Other Questions/Comments:

Credit Card Verification:

Card Number:

Name as it appears on card:

Nickname:

Card Expiration Month:

Exp Year:

Address Line 1:

Address Line 2:

City:

State: Zip:

eCheck/Bank Draft:

Bank Name:

Bank Routing Number:

(9-digit number)

Your Account Name:

(Your name on your bank statement)

Your Account Type:

Account Number: