Independence 72 Free DVD Claim FREE DVD Contact Information: First Name (required) Last Name (required) Contact Number (required) Email (required) I Am A: (required) —Please choose an option—PerformerSponsorMember Performers, please enter the name of your choreograph: (required) Sponsors, please enter the name of your company: (required) Mailing Address: Address #1 (required) Address #2 City (required) State (required) —Please choose an option—AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming Zip Code (required)