2024 Summer Intensive Video Audition
Start Date/Time: End Date/Time:
Fee per Student: Room:
* - denotes required fields
Family Information
First Name:* Last Name: *
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
I am interested in attending Week One of the intensive (July 8-July 12)*
I am interested in attending Week Two of the intensive (July 15-July 19)*
I am interested in attending Week Three of the intensive (July 22-July 26)*
I am interested in attending Week Four of the intensive (July 29-August 2)*
What academic school is your child currently attending?*
What dance studio is your student currently dancing at?*
Is your student on pointe?*
If yes, please give the month and year they began their pointe training.
Does your student have any allergies or physical limitations that LABA should be aware of?*
Additional Information:
Other Questions/Comments:
Credit Card Verification:
Card Number: *  
Name as it appears on card: *
Card Expiration Month: *   Exp Year: *
Address Line 1: Address Line 2:
City: State: Zip:*