LET’S GET STARTED! Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.1ABOUT YOU!2RELEASE FORMS3Which YEAR will you dance in L.A.? *20252026For our two-week dancer program onlyDecemberJanuaryFebruaryWhich MONTH will you dance in L.A.? MarchAprilMayJuneJulyAugustSeptemberOctoberNovemberName *FirstLastBirthdateMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Upload your photo/headshot * Drag & Drop Files, Choose Files to Upload Email *Cellphone *Address *Address Line 1Address Line 2CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryInstagram *TikTokEMERGENCY CONTACT Emergency Contact Name *FirstLastEmergency Contact Phone *Emergency Contact Email *Emergency Contact Address *Address Line 1Address Line 2CityState / Province / RegionPostal Code--- Select country ---AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBolivia (Plurinational State of)Bonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongoCongo (Democratic Republic of the)Cook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Kingdom of)EthiopiaFalkland Islands (Malvinas)Faroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIran (Islamic Republic of)IraqIreland (Republic of)Isle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea (Democratic People's Republic of)Korea (Republic of)KosovoKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesia (Federated States of)Moldova (Republic of)MonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth Macedonia (Republic of)Northern Mariana IslandsNorwayOmanPakistanPalauPalestine (State of)PanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint Maarten (Dutch part)SlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyrian Arab RepublicTaiwan, Republic of ChinaTajikistanTanzania (United Republic of)ThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUgandaUkraineUnited Arab EmiratesUnited Kingdom of Great Britain and Northern IrelandUnited States Minor Outlying IslandsUnited States of AmericaUruguayUzbekistanVanuatuVatican City StateVenezuela (Bolivarian Republic of)VietnamVirgin Islands (British)Virgin Islands (U.S.)Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsCountryWhat are some of the things you want to do while in L.A.?Are you allergic to any food, medicine, animal?YesNoIf yes, please describe:In case of emergency, is there ANY medical condition we should know about to help in your medical care? For example, are you taking medications that a doctor should know about before administering medical care? Please note, this will NOT disqualify you from THE PROGRAM. It is just for your health and safety.YesNoIf yes, please describe:NextElectronic Signature/Date Required. L.A. Cultural Exchange is a program under Artists Exchange Group Inc. The L.A. Cultural Dance in L.A. program will be referred to as THE PROGRAM. Photo & Date Release I grant permission to Artists Exchange Group, Inc. the right to take and publish my photographs and video for the marketing (promotion, publicity, advertising) of THE PROGRAM. Marketing can be print or digital media. Marketing will only use the dancer's name/handle and country and no other personal information unless requested. Signature Clear Signature DateMM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Risk of Injury Release & Waiver I acknowledge and understand that there may be a risk of injury involved in activities which I will choose to engage in during my voluntary participation in THE PROGRAM, including but not limited to sports and/or performing arts instruction/performance. I agree to release, waive, discharge, hold harmless and indemnify, on behalf of respective officials, agents, employees, directors, members and other staff members of Artists Exchange Group, Inc., from liability, as well as my personal representatives, next of kin, for any and all claims from or out of any injury, known or unknown, to property or body, that I may suffer from my voluntary participation in THE PROGRAM. I accept full financial responsibility for any costs associated with my participation in activities during THE PROGRAM and at performing arts facilities. Signature Clear Signature Date *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Liability Release I am responsible for any claims, damages, actions, liability and expense concerning accidents, injury, loss of life and loss of property incurred by my actions. I agree to indemnify and hold Artists Exchange Group, Inc., its employees, officers, owners, agents and representatives harmless from all claims, damages, actions, liability and expense concerning accidents, injury, loss of life and loss of property arising from my participation in THE PROGRAM. I agree to pay for damages/losses incurred to Artists Exchange Group, Inc., within 45 days or less from the time the action/incident was taken. Any claim or dispute arising from or related to your participation in THE PROGRAM will be settled by mediation and, if necessary, legally binding arbitration, in accordance with the State of California Arbitration Commission. Signature * Clear Signature Transportation I understand that while with THE PROGRAM I will be traveling via METRO subway, buses and rideshares like LYFT and Uber. If I choose to participate in activities alone or not organized by THE PROGRAM, I will be finacially responsible for my own transportation. Date *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Signature * Clear Signature Date *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Dancer and Dorm Rules Guests: No guests are allowed in the dorm. No exceptions. Shoes: No shoes in dorm. Water: We are in a permanent drought. Showers should be less than 10 minutes. Turn off water while brushing teeth and dishes. Cleaning: All items must be put away, off the floor, tables and counters for the weekly house cleaner. Bed clothes must be put in designated bags for weekly cleaning. Floor: Run the robot vacuum daily. Meals: Dancers are responsible for their own meals while in the dorm and on non-group organized activities. Quiet Time: Is 10PM and violations will result in an $80 fine, $160 for the second violation. Damages: Dancers are responsible for property damages, including broken windows, walls, doors, toilet, shower doors and walls. Bathroom: Only toilet paper can go in the toilet. Any other item will cause an overflow. Personal Items: Dancers are responsible for their personal items. Any valuable (monetary or personal) should be placed in their locked suitcase. Drugs: Drug use for non-medical reasons is forbidden. Dancers will not buy, sell or possess any controlled and/or illegal drug, unless it is prescribed and approved by the student's physician. Alcohol: It is against U.S. law for ANY persons under the age of 21 to buy or use alcohol. There is no alcohol in the dancer dorm. Cigarettes: It is against the law for ANY person under the age of 21 to buy cigarettes. There is no smoking in the dancer dorm. Personal Health Insurance: All dancers must maintain a personal health insurance policy during their participation in the program, paid by the dancer. Health Issues: THE PROGRAM has the right to terminate a dancer immediately if a dancer's physical or mental health issues disclosed or not disclosed on the application, including eating disorders, put the dancer(s) in danger. Dancers will be sent home at their own expense. Laws: While in the program, dancers are under the jurisdiction of local, state and federal laws. Sexual Harassment: We have a zero tolerance policy toward ANY and ALL sexual misconduct. If a dancer experiences sexual harassment, it must be reported immediately to the dance captain and director. Dancer Disputes: Dancers come from all over the world but with the same goal. Be open to new ideas, languages, customs and traditions. You are a team and should resolve problems democratically. Sexism, homophobia and racism are never tolerated. I agree to abide by the Dancer/Dorm rules. Signature * Clear Signature Date *MM123456789101112DD12345678910111213141516171819202122232425262728293031YYYY202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920NextElectronic Signature/Date Required. DANCER'S NAME *FirstLastThe Nonrefundable $300 USD Deposit Is To Hold Your Place In Our Program. It Will Be Deducted From The Total Program Fee. If you have any problems with submitting your deposit to hold your spot, please let us know: [email protected] PAYER'S NAME *FirstLastApplication FeePrice: $300.00Total$0.00Payment Method *RevolutStripeStripe Credit Card *PAYER'S EMAIL *PreviousSubmit Application