Registration Form

Dance USA

6079 50th Ave. SW

Montevideo, MN 56265

320-269-5150 – fax 320-269-5160 – cell 320-226-0366

www,danceusa.biz – e-mail  Sharon@danceusa.biz

 

 

School _______________________ Team Name _____________________

School Address ___________________      __________________________

School Phone # _________________________ Fax # __________________

The information you will need for the competition will be faxed or e-mailed to you; please list the fax # and e-mail address to be used: 

Fax # ____________________  e-mail address _______________________

                                                       (Please write legibly or you will not receive your e-mail)

Coach (# 1) Name: __________________           Coach (#2) ________________

Address: __________________________ Address: __________________

__________________________________         _________________________

Phone # where you can be reached or a message can be left:

Phone # : __________________________    Phone # __________________

Cell # : ____________________________   Cell # ____________________

E-Mail ____________________________ E-Mail ___________________

 

Please circle the competitions you are registering for:

 

Competition:       RCW HS         Yellow Medicine East          ACGC

Date                       Jan. 2, 2010                 Jan. 9, 2010                           Jan. 16, 2010                   

Registration fee            $100.00                       $100.00                                  $100.00                             

                                     

Competition           

Date                                 

Registration fee                  

                  

The registration fees are per competition and per team (Varsity, JV and Jr. High are separate teams).  Each School can submit one check for all competitions.

 

 

Please complete as much of the Data portion of the registration from on the other side of this sheet as you have available at this time.  The complete data can be e-mailed to Sharon@danceusa.biz at a later date.    

Page 2

 

Name of your team _________________ # of dancers on the team ________

 

            A   AA    AAA     A-JV        AA-JV         AAA-JV      Jr. High ↓

 

Division your team is in: ↑_______________________________________↑

 

Can your Varsity share a room with the JV? __________________________

 

Captains: _____________________________________________________

 

Registering for:  High Kick Only? ____ Jazz Funk Only? _____ Both?____

 

Leave blank the information that you don’t have at this time and e-mail it to us as soon as possible (to Sharon@danceusa.biz)

 

Precision High Kick Song: _______________________________________

Choreographers: _______________________________________________

 

Jazz Song: _______________________________________________

Choreographers: _______________________________________________

 

Coach’s Names: _______________________________________________

                         ________________________________________________

 

Capitan’s Names: ______________________________________________

                         ________________________________________________

 

          Please send a completed registration form for each team that will be attending.  A registration fee must be received in our office to be properly registered.  Your school can cut one check to Dance USA to cover the entry fees for all the competitions Dance USA is organizing that you wish to attend.  If you have any questions, please contact us at Dance USA.