Purple Heart Badge
Dancer Name *
Your answer
Date of the dance *
MM
/
DD
/
YYYY
Club Name *
Caller / Cuer 1 *
Other Caller / Cuer 1
Your answer
Caller / Cuer 2 *
Other Caller / Cuer 2
Your answer
Caller / Cuer 3 *
Other Caller / Cuer 3
Your answer
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