Become an Ambassador

Name*

First Last

Age*

Dance Studio

State*

How can we reach you?*

Choose at least one way for us to contact you. Hold the shift key to select multiple options.

Email Address*

Instagram*

Facebook*

Twitter*

Please explain in 200 words or less why you want to be a voice for children fighting cancer.*

Please submit a high quality dance image that we can use to post on the Dance Hope Cure website or social media.*

*

If I am under 18, I have permission from my parents to be featured on the Dancers vs Cancer website or social media.

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