APPLICATION/REGISTRATION FORM Submission Deadline – October 25, 2022 This form MUST be completed by Parent or Legal Guardian! * Required fields Please enable JavaScript in your browser to complete this form.Participant's Name *FirstLastParticipant's Age *Please list all dancers along with their agesParent/Guardian Name *FirstLastParent/Guardian Email *EmailConfirm EmailParent/Guardian Phone Number *Studio NameParticipants' Names and AgesPlease list all dancers along with their ages using format reflected in the field above (First Last - Age, First Last - Age, et cetera)Teacher's Name *FirstLastTeacher's Email *EmailConfirm EmailTeacher's PhonePhone number with area codeNomination *SoloDuetTeacher & StudentTeam FormationAge Category *5 to 89 to 1314 to 181. Dance Title *1. Link on self YouTube video *Additional CommentsPAYMENTNon-refundable Registration Fee for the performance of one dance lasting 1.5 - 2 minutes.Number of Nominations (solo/duet/teacher-student)1 Nomination - $30.00Group Formation Registration FeesDancer 1 - $15.00Dancer 2 - $15.00Dancer 3 - $15.00Dancer 4 - $15.00Dancer 5 - $15.00Dancer 6 - $15.00Dancer 7 - $15.00Registration Fee for GROUP DANCE is $15 per participant. In case of providing payment for the group please make sure TOTAL covers all participants (for example, in case of 4 dancers: $15x4=$60). Each click adds $15 to the total amount. The second click on the SAME box REMOVES $15 from the Total.Total$0.00Payment Method *PayPalCredit CardIMPORTANT! We DO NOT keep ANY financial information! All payments are processed through PayPal and Stripe gateways.Credit CardCardName on CardCredit Card *Card NumberSecurity CodeName on CardExpirationMM123456789101112/YY2627282930313233343536I certify that all of the information above is accurate. *YESNameSubmit
