2005 Tarheel Dance Classic
September 22-25, 2005
Complete
this form and enclose payment. Your event passes will be waiting upon arrival.
Absolutely no refunds under any circumstances.
Confirmations will be made by email only!
Name ______________________________
Address ______________________________
City, State ______________________________ Zip ________________
Day Phone ______________________________
Evening Phone ______________________________
E-Mail Address ______________________________
Submission of this form by the
party or parties listed above signifies the following statement: “We agree to
hold the organizers of this event and their agents harmless from all suits,
claims, or demands of every kind and character arising out of and in
conjunction with this event. We hereby authorize the reproduction, sale,
copyright, exhibition, broadcast, and/or distribution of any videotape without
limitations. We understand the physical risks of entering dance competition and
social dancing and assume full responsibility for any injury or personal
damages resulting from the event named above. We certify that we are 18 years
of age or older (applicable to Legal Guardian if under 18 years of age.)”
Signature ______________________________ Date ________________
|
COMPETITION
& EVENT FEES |
||||
|
Please
Select From The
Following |
Qty |
Before 8/22 |
After 8/22 |
Total |
|
Weekend Event Pass Admission to all free activities, including 3-day event
pass, all workshops & nightly dances. EXCLUDES DINNER & SHOW |
|
$70 |
$85 |
|
|
LDI Member Event Pass Same admission as Weekend Event Pass. LDI MEMBERSHIP #
____________ |
|
$60 |
$75 |
|
|
Junior Weekend Event Pass Ages 15 & Under. EXCLUDES DINNER & SHOW |
|
$35 |
$50 |
|
|
Friday Only Pass Admission to all free
activities, workshops & dance. |
|
$35 |
$45 |
|
|
Saturday Only Pass Admission to all free
activities, workshops & dance. EXCLUDES DINNER & SHOW |
|
$50 |
$60 |
|
|
DINNER & SHOW ONLY (not avail after 9/21/05) |
|
$30 |
$35 |
|
|
Sunday Only Pass Admission to all free
activities, workshops & dance. |
|
$35 |
$45 |
|
|
Competitors Only Line Dancers per dance. |
|
$0 |
$15 |
|
|
Line Dance Judge Training Check with Event Director for times. |
|
$35 |
$40 |
|
|
Step Description Booklet $3.00 off to LDI members. Add $3.00 for shipping if not picked up at the event. |
|
$13 |
$15 |
|
|
EXCLUDES WORKSHOPS & DINNER SHOW |
|
$20 |
$25 |
|
|
Workshop Video (VHS or DVD) Includes all dances. $5.00 off to LDI member Includes Shipping by USPS Parcel Post |
|
$35 |
$35 |
|
|
TOTAL
EVENT FEES |
|
|||
Make checks or money
orders payable to: Scott Hucks