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*** FREE ADMISSION AT ALL COMPETITIONS***

SUMMERDANSE ENTRY FORM

Information: 716-549-4484 E-mail bevsdance4484@hotmail.com

ENTRY DEADLINE...ALL ENTRIES MUST BE POSTMARKED 30 DAYS BEFORE EACH COMPETITION

LATE ENTRIES...$5.00 PER PERSON-PER ENTRY, UP TO 15 DAYS BEFORE COMPETITION.
ALL LATE ENTRIES MUST BE PAID FOR IN CASH, MONEY ORDER OR CERTIFIED CHECK.

  1. Please use only one entry form for each routine.
  2. Please refer to the Summerdanse rules when completing your entry.
  3. Please enclose a check or money order for the full amount.
  4. NO ENTRIES ACCEPTED THE DAY OF THE COMPETITION!
  5. Information must be completed in all 5 parts of application.

***COMPETITION SITES--PLEASE CHECK ONE***

1

PITTSBURGH, PA ( April 18) ____

CLEVELAND, OHIO (April 25) ___

ROCHESTER, NY (May 16) ___

BUFFALO/CANADA I ( May 22 & 23) ___

BUFFALO/CANADA II (June 12 & 13)___

Ages:(6yrs & under) (7-8)(9-10) (11-12) (13-14) (15-16) (17-19) (20-29) (30yrs. & over)

Age Division:_____________ Number of students in routine:_____________

Age as of April 1st, 2010 Average age - drop decimal point


_________________________________________________________________________

*** LEVEL - PLEASE CHECK ONE ***

Recreational (3 hours or less of classes per week)____ Competitive____

 

***DANCE DIVISIONS -- PLEASE CHECK ONE***

2

Jazz ___ Ballet/Pointe ___ Musical Theatre___ Acro ___ Lyrical/Modern ___

Tap ___ Production ___ Hip Hop ___

 

________________________________________________________________________________________________________________

***CATEGORY -- PLEASE CHECK ONE***

 

3

Solo ___
$48.00

Duet/Trio___
$28.00 per dancer

Small Group (4-9)___ $20.00 per dancer

Production ___
$20.00 per dancer

Large Group
(10+) ___
$20.00 per dancer

LATE FEE $5.00 ----- PROGRAMS $4.00

Prices are Listed US funds
TOTAL AMOUNT ENCLOSED:_______________

Please make checks payable to B. Grodesky and mail entry to:

SUMMERDANSE COMPETITION - 719 BEACH ROAD - ANGOLA, NY 14006

_______________________________________________________________________________________________________________

4

Title of Music: __________________________________________________________________

Name of dance teacher:___________________________________________________________

Name of dance studio:____________________________________________________________

Studio address:_______________________________ City:______________________Zip:______

Studio phone:__________________________ Fax:______________________

Home phone of studio owner:_________________________ E-mail________________________

________________________________________________________________________________________________________________

Please list the following information for students on this entry form:- Continue names on back

5

Name

_____________________________________

_____________________________________

_____________________________________

Age as of April 1st

________________

________________

________________

Birthdate

_____________

_____________

______________

 

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