CONVENTION REGISTRATION FORM
Applicant:
Studio:
Email:
Street Address:
City:
State/Province:
Zip Code:
Home Phone:
Studio Phone:
Convention City:
Convention Dates Attending:
From:
(mm/dd/yyyy)
To:
(mm/dd/yyyy)
Name of Registrant
Type of Registrant
Rates
Sub-total:
Multi-city Discount:
(none)
second city 10%
third city 20%
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 Convention Registration page of Extreme Dance's website located at:
http://www.xtremedance.com/convention_reg/convention_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.
Please check here:
