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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 19) ____

CLEVELAND, OHIO (April 26) ___

ROCHESTER, NY (May 9) ___

 

BUFFALO/CANADA I ( May 16& 17) ___

BUFFALO/CANADA II (June 13 & 14)___

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, 2009 Average age - drop decimal point


_________________________________________________________________________

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

2

Jazz ___ Ballet/Pointe ___ Open ___ Acro ___ Lyrical/Modern ___ Tap ___

Production ___ Novice- Groups only ___ Hip Hop ___

 

________________________________________________________________________________________________________________

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

 

3

Solo ___
$48.00

Novice Group ___ $20.00 ea.

Duet/Trio___
$28.00 ea.

Small Group (4-9)___ $20.00 ea.

Production ___
$20.00 ea.

Large Group (10+) ___ $20.00 ea.

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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