Premier All Stars – Premier Member Enrollment

Student Name*
First Last
Age*
Please enter a number from 4 to 18.
Date of Birth*
MM slash DD slash YYYY
Parent Name*
First Last
Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Max number of group dances in which you would like to compete
I am interested in going to Nationals.
Nationals will be in January in Texas.
- Yes
- No