2016-17
Dance Competition Registration Form
ORGANIZATION/CONTACT INFORMATION
SELECT YOUR TOUR
___________________________________________________________________ Organization Name
___________________________________________________________________ Organization Address
___________________________________________________________________ City
State
Zip
___________________________________________________________________ Phone Fax
___________________________________________________________________ Contact Name
___________________________________________________________________ Contact Phone
STUDIO LIVE! VA March 4, 2017 STUDIO LIVE! SC March 25, 2017 STUDIO LIVE! OH April 22, 2017 STUDIO LIVE! FL May 20, 2017 STUDIO LIVE! Nationals July 22, 2017
Contact Email
PERFORMANCE CATEGORY
AGE DIVISION
DIFFICULTY LEVEL
COMPETITION DIVISIONS
Acro Jazz Tap Ballet Lyrical Teacher Clogging Modern Contemporary Musical Theater Hip Hop Open Improv Pointe
Mini Petite Junior Teen Senior Open/Adult
Recreational: 1-2 hours/week in the studio Premier: 3-5 hours/week in the studio Elite: 6+ hours/ week in the studio
Solo Duet/Trio Small Group (4-9) Large Group(10-19) Line (20-25) Production (26+)
ROUTINE 1
Routine Name ____________________________________________________________________ # of Dancers ____________
ROUTINE 2
Routine Name ____________________________________________________________________ # of Dancers ____________
ROUTINE 3
Routine Name ____________________________________________________________________ # of Dancers ____________
ROUTINE 4
Routine Name ____________________________________________________________________ # of Dancers ____________
ROUTINE 5
Age 3-7 Age 8-10 Age 11-12 Age 13-15 Age 16-19 Age 20+
Routine Name ____________________________________________________________________ # of Dancers ____________
Performance Category __________________________________________ Age Division ________________________________ Difficulty Level _________________________ Competition Division ________________________________________________
Performance Category __________________________________________ Age Division ________________________________ Difficulty Level _________________________ Competition Division ________________________________________________
Performance Category __________________________________________ Age Division ________________________________ Difficulty Level _________________________ Competition Division ________________________________________________
Performance Category __________________________________________ Age Division ________________________________ Difficulty Level _________________________ Competition Division ________________________________________________
Performance Category __________________________________________ Age Division ________________________________ Difficulty Level _________________________ Competition Division ________________________________________________
Registration Deadline: The registration deadline for each competition is four (4) weeks prior to the competition date. Registrations received after the deadline will be assessed a $100 late fee. Entry Fees: Entry fees are required to be paid in U.S. funds only and are non-refundable. All checks returned are subject to a $35 NSF fee plus the incurred late fees. No more than two (2) checks for each registration. Payments made within two (2) weeks must be in the form of cash (please do not mail cash), cashier’s check, or credit card. Cancellation: STUDIO LIVE! reserves the right to cancel any event that does not meet the minimal number of acceptable entries. In the event this should occur, all entry fees will be refunded. There will be NO refunds on entries after the minimum number of entries have been received and the competition has been confirmed. Inclement Weather Policy: In the event that a competition has to be re-scheduled or canceled due to inclement weather or unforeseen circumstances, all registration fees will be applied to future STUDIO LIVE! events. No refunds will be given.
ROUTINE 6
Routine Name ____________________________________________________________________ # of Dancers ____________
ROUTINE 7
Routine Name ____________________________________________________________________ # of Dancers ____________
ROUTINE 8
Routine Name ____________________________________________________________________ # of Dancers ____________
ROUTINE 9
Routine Name ____________________________________________________________________ # of Dancers ____________
ROUTINE 10
Routine Name ____________________________________________________________________ # of Dancers ____________
Performance Category __________________________________________ Age Division ________________________________ Difficulty Level _________________________ Competition Division ________________________________________________
Performance Category __________________________________________ Age Division ________________________________ Difficulty Level _________________________ Competition Division ________________________________________________
Performance Category __________________________________________ Age Division ________________________________ Difficulty Level _________________________ Competition Division ________________________________________________
Performance Category __________________________________________ Age Division ________________________________ Difficulty Level _________________________ Competition Division ________________________________________________
Performance Category __________________________________________ Age Division ________________________________ Difficulty Level _________________________ Competition Division ________________________________________________
SOLOISTS ONLY - COMPLETE THIS PORTION (INDEPENDENTS ONLY) Name _____________________________________________________________________________________________________ Birth Date ________/_________/_________ Age ________ Phone (_____) _____________________________________________ Dancer’s Email _______________________________________________________________________________________________ (if independent, submit address)
Street Address _______________________________________________________________________________________________ City ______________________________________________________________ State _____________ Zip ___________________
PAYMENT $90 for each Solo
$90.00 x
_____ # of soloists
$55 per person Duet/Trio
$55.00 x
_____ # of dancers
$50 per person for Small & Large Groups $50.00 x
_____ # of dancers
$40 per person for Line & Production
$40.00 x
_____ # of routines
Total Entry Fee Enclosed CREDIT CARD
Visa
= _____ total
= _____ total
= _____
METHOD OF PAYMENT Check or Money Order (make checks payable to Eastern) School Purchase Order # ____________
total
= _____ total
Credit Card (please fill out credit card information below)
_____
AMEX (Columbus Competition Only)
Master Card
Discover
Account # ______________________________________ Cardholder’s Name ____________________________________________ Exp. Date _________________ Security Code ________ Street Address __________________________________________________ State _______ Billing Zip _______________ Signature ________________________________________________________________ Return completed registration form & payment to: STUDIO LIVE! Competitions | 825 Grove Rd., Suite 8 | Midlothian, VA 23114 | fax: 804.893.4863
[email protected]
2016-17 Contestant Roster Duplicate this roster for each routine.
NAME OF ROUTINE _______________________________________________________________________ Name
Date of Birth
Name
Date of Birth
1. ________________________________________
26. ________________________________________
2. ________________________________________
27. ________________________________________
3. ________________________________________
28. ________________________________________
4. ________________________________________
29. ________________________________________
5. ________________________________________
30. ________________________________________
6. ________________________________________
31. ________________________________________
7. ________________________________________
32. ________________________________________
8. ________________________________________
33. ________________________________________
9. ________________________________________
34. ________________________________________
10. _______________________________________
35. ________________________________________
11. _______________________________________
36. ________________________________________
12. _______________________________________
37. ________________________________________
13. _______________________________________
38. ________________________________________
14. _______________________________________
39. ________________________________________
15. _______________________________________
40. ________________________________________
16. _______________________________________
41. ________________________________________
17. _______________________________________
42. ________________________________________
18. _______________________________________
43. ________________________________________
19. _______________________________________
44. ________________________________________
20. _______________________________________
45. ________________________________________
21. _______________________________________
46. ________________________________________
22. _______________________________________
47. ________________________________________
23. _______________________________________
48. ________________________________________
24. _______________________________________
49. ________________________________________
25. _______________________________________
50. ________________________________________
Return completed registration form & payment to: STUDIO LIVE! Competitions | 825 Grove Rd., Suite 8 | Midlothian, VA 23114 | fax: 804.893.4863
[email protected]
