COMPETITION REGISTRATION FORM

Applicant:
Studio:
Email:
Street Address:
City:
State/Province:
Zip Code:
Home Phone:
Studio Phone:
Competition City:
Competition Type:
Teacher/Choreographer:
Name of Routine:
Style of Routine:
Dancers Enter:
Name of Competitor Type of Competitor Age Birth Date (mm/dd/yyyy)

  Total Number of Competitors:
  Average Age of Competitors:
  Age Division:
  Category:
  Total Amount Due:

Payment Type: Check:    Paypal:  

WE DO NOT ACCEPT FAXED REGISTRATION FORMS
  • REGISTRATION FORMS and PAYMENT must be received by the Cut-Off Date to be eligible for Discount Rates. Registration is not guaranteed until all forms and payment have been received. If your payment method is through PAYPAL, we must receive your registration 7 days prior to the cut-off date to allow time for processing. You must complete your PayPal payment before the cut-off date to be eligible for discount rates. SCHOLARSHIPS must submit original Extreme Dance scholarship certificate with registration forms. Registration Walk-Ups will be accepted, space permitting. There is a $25.00 fee for each returned check. Registration is Non-Refundable and Non-Transferable. Lost or removed I.D. Bracelets will require full repayment.

  • I have read and agree to all rules and policies on the Competition Registration page of Extreme Dance's website located at:
    http://www.xtremedance.com/competition_reg/competition_reg.html.
RELEASE WAIVER:
I, the undersigned on behalf of the parties registered jointly and severally hereby forever releases, discharges, and acquits EXTREME DANCE CONVENTIONS and DM CREATIVE PRODUCTIONS INC., it’s directors, independent contractors, instructors, and volunteers from any and all claims for damages or injuries of any kind, nature, or description resulting from or related in any way to the participation in EXTREME DANCE CONVENTIONS & COMPETITIONS.
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