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1.
Applicant's Full Name:
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2.
Parent's or Legal Gardians Full Name:
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3.
Applicants Date Of Birth: MM/DD/YY
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4.
Address:
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5.
Phone And/ Or email (so we can reach you if your recieve the sponsership):
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6.
Applicant's Gender:
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7.
Applicant's Current US Adult Shoe Size: (Yes, we realize this will probably change)
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8.
Applicants Current US Adult Jacket Size:
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9.
How long the applicant has been dancing?:
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10.
What forms of dance does the applicant do?:
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11.
Past Achievements (ex. Runner up at the 2007 Holiday ball Bronze Youth) (Please not we will not pick someone based soley on wins. We are looking for heart too. So don't worry if you are not at the top yet.)
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12.
What are the applican't current AND furture goals in dancesport?:
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13.
Other interests:
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14.
Other things about the applicant:
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15.
Please send a photo of your child to info@amysafter5.com or mail to: ATTN: AmysAfter5.com 2283 Currier Pl. Fairfield, CA 94533 after you have sent this form along with you signature attached to the below statement.
I the undersigned; understand that if my Child receives this Sponsorship. AmysAfter5.com and ShopDancesport.com have the right to use my child's name, photo's and other information that I have provided them (we will not give out your address, phone number or email.) on their websites and in their ads. As part of my child's sponsorship he or she will represent AmysAfter5.com and ShopDancesport.com in a respectful manner and wear AmysAfter5.com shoes and the warm-up jacket that your child will receive as well as tell others about AmysAfter5.com and ShopDancesport.com while using the duffle bag that we will provide. I also understand that AmysAfter5.com and ShopDancesport.com will not be held responsible for the lose or theft of any item(s) you receive from us and we do not guarantee your child will win or lose the sponsorship or any competition. We also, will not be held responsible for any injuries your child may receive while participating in this sport. Sponsorship last for 1 year starting on July 1st 2009 and ends June 30th 2010.
Please sign below if you have read and agree to the above statement:
Parental or Legal Guardians signature: ____________________________________________________
Date: ___________
Video is optional but appreciated:
I will send you a video through email or snail mail:
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16.
Thank You for your Application we will get back to you by July 1st 2009.
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