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Name*
First Last
Email*
Phone*
Performance Type*
- Pole
- Aerial Silk
- Lyra
- Liquid Motion/Dance
- Other (Please describe below)
Description (if checked the "other" field above)
Is this a group performance?*
- Yes (please tell us how many people will be involved below)
- No
Number of performers (if you checked "yes" above)
Please provide a short description of you performance and what type of music you will be using.*