| DIVISION: (Check One) ** Please
Note: New Age Divisions |
 Miss Dance |
Teen Miss
|
Junior Miss
|
Petite Miss
|
| Mr. Dance |
Teen Mr.
|
Junior Mr.
|
Master |
| ENTRANT'S PERSONAL INFORMATION: |
| Name of Entrant: |
___________________________________________________ |
| Name of Parent or Legal Guardian: |
___________________________________________________ |
| Mailing Address: |
___________________________________________________ |
| City / State / Zip Code: |
___________________________________________________ |
| Home Telephone: |
_(______)______________________ |
| Entrant's Age: |
____________ Birthdate (mm/dd/yy): ___________________ |
| MEMBER TEACHER INFORMATION: |
| Teacher of Record: |
___________________________________________________ |
| Teacher of Recognition: |
___________________________________________________ |
| Studio Name: |
___________________________________________________ |
| Studio Address: |
___________________________________________________ |
| City / State / Zip Code: |
___________________________________________________ |
| Home Telephone: |
_(______)______________________ |
| Studio Telephone: |
_(______)______________________ |
VIDEO ORDER FORM:
All Solo Title Videos will be sold through Videoworx. Each tape will contain
footage of the OPENING ROUTINE, YOUR ROUTINE, and THE AWARDS CEREMONY.
Each contestant will receive an order form at the first rehearsal on October
23, 2011.
|
