Official Regional Solo Registration Form

ALL ENTRIES MUST BE POSTMARKED 21 DAYS BEFORE THE DATE OF THE COMPETITION

Please provide the following  information: (Use Tab to move between fields)

Are you a current client with DMI?

Yes        No
Select Competition                                                                                  Competitions

Studio/School Name

                 Lakeland Dance Challenge-Lakeland, FL Jan 16, 2010     
Director's Name                  Curtain Call Dance Challenge-Regionals Mobile, AL Feb 6

                      Address

                  The Big Easy Dance Event and Convention- New Orleans, LA Mar 27,28
City                  Sun City Dance Fest-Nationals -Panama City,  Apr 17,18 
State     Zip Code                   Dallas, Tx Area TBD 2010
Email Address                  Myrtle Beach, SC Area TBD 2010
Home Phone
Cell Phone
Studio Phone   Fax Number
Name of Routine/Music Title
  Name                                         Date of Birth   Age

Performers

       (mm/dd/yyyy     *Age is as of the date of the competition )
                                          
                                          
   

                                    Age Division 

                                       Categories 

                                       Group Size

                              

Solo $80.00
Mr & Miss Photogenic $25.00     Miss Photogenic      Mr Photogenic 
Best Costume $25.00
Title Division $25.00    Dance Magic Title    Miss     Mr
Entry Fee Total
Payment Type
Any dancer competing in a dance competition takes certain inherent risks.  These include, but are not limited to, sprains, bruises, pulled muscles and broken bones.  Participation in this competition indicates the acceptance of such risks.  Therefore, the above signed guardians hereby release and will not hold DANCE MAGIC Inc, its directors, officers or staff liable or responsible for injuries or damages sustained while participating in any activity related to DANCE MAGIC Inc. Competitions/Convention. All studio owners, directors, teachers and choreographers do hereby grant permission for DANCE MAGIC Inc to use their choreography, photos, electronic/video images and/or likeness for appearance on video, television or any advertisement of our events without any form of compensation.
 
I accept the waiver and release terms on behalf of my performers and will forward a completed and signed copy to Dance Magic before competition begins.
 

(Click the above checkbox to accept rules. Click the Recalculate button to compute total. Click Submit form.)