|
Routine Name ______________________________________________________
Prop: _______________________________________________________________
| (CIRCLE): |
DUO |
TRIO |
GROUP |
LINE |
|
List of Dancers in Routine
|
| # |
Name |
Birthdate |
Age |
|
# |
Name |
Birthdate |
Age |
| 1 |
|
|
|
|
11 |
|
|
|
| 2 |
|
|
|
|
12 |
|
|
|
| 3 |
|
|
|
|
13 |
|
|
|
| 4 |
|
|
|
|
14 |
|
|
|
| 5 |
|
|
|
|
15 |
|
|
|
| 6 |
|
|
|
|
16 |
|
|
|
| 7 |
|
|
|
|
17 |
|
|
|
| 8 |
|
|
|
|
18 |
|
|
|
| 9 |
|
|
|
|
19 |
|
|
|
| 10 |
|
|
|
|
20 |
|
|
|
| (Continue on back if necessary) |
| |
|
|
|
|
| Circle: Initial entry @ $25.00 per dancer / Additional entry @ $15.00 per dancer |
| Number of dancers in this routine |
__________
|
@ $___________
|
=
|
$___________
|
 Dance
Masters of California, Inc. , its Board of Directors, the Santa Clara
Convention Center, and the Hyatt Hotel are not responsible for any loss
or damage during this event.
I
give Dance Masters of California, Inc. permission to use the name, likeness,
or photograph of myself or any of my students participating in the event
in any Dance Masters Publications.
| Studio Name_________________________________________________________________ |
| Teacher of Record_____________________________________________________________ |
| Choreographer________________________________________________________________ |
| Signature of Sponsor Teacher ____________________________________________________ |
| Date: __________ |
Daytime Phone: _______________ |
Fax: ________________ |
| Email: __________________________________________ |
|
