Your Information

PARENT ORDER FORM

Each gift may be personalized with the Dancer’s First Name, Name of Dance School and Recital Year free of charge.

First Name*

Last Name*

Email*

Phone*

Date of Recital*

Order Your Gifts

Item#1

Name of Item

Color of Costume or Pillow

Color of Bear (Refer to the Products Page)

Do you want to Personalize Your Bear or Pillow free of charge?
 Yes No

First Name of Dancer (If none leave Blank)

Name of Studio (If none leave Blank)

Year of Recital

Item#2 (If none keep fields Blank)

Name of Item

Color of Costume or Pillow

Color of Bear (Refer to the Products Page)

Do you want to Personalize Your Bear or Pillow free of charge?
 Yes No

First Name of Dancer (If none leave Blank)

Name of Studio (If none leave Blank)

Year of Recital

Item#3 (If none keep fields Blank)

Name of Item

Color of Costume or Pillow

Color of Bear (Refer to the Products Page)

Do you want to Personalize Your Bear or Pillow free of charge?
 Yes No

First Name of Dancer (If none leave Blank)

Name of Studio (If none leave Blank)

Year of Recital

Shipping

Is your Dance Studio participating in the FREE SHIPPING program to your Studio?*
 Yes No

If “Yes” please provide your Studio Shipping Address (otherwise leave blank):

Name of Studio

Studio Address

Address Line 2

City

State

Zip Code

Are we shipping to your address?*  Yes No

If “Yes”, please provide your Shipping Address (otherwise leave blank):

First Name

Last Name

Shipping Address

Address Line 2

City

State

Zip Code

Phone Number

If we are shipping to your address shipping charges will be added:

Small Bears (Nina): $8.25
Medium Bears (Katrina, Jazmin, Gemma, Hillary/Henry, Peggy): $10.25
Large Bears (Bettina, Tony, Tara, Gina, Cherrie, Hannah/Harry, Clara, Snowflake, Angel, Sugar Plum Fairy, Waltz of the Flowers): $12.25
$15.25 postage, or less, for multiple gifts.

Payment

Total Amount of Purchases*

Payment Method*

Name on Card*

Card Number*

Exp. Date*

CSC* (3-Digit Security Code on back of card)(American Express Card holders please put your 4-Digit code from the front of your card.)

Billing Address*

City*

State*

Zip Code