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2011 Phone # UCWDC # Birth Date Phone # UCWDC # Birth Date Registration Form E-mail E-mail Submission of this form stipulates: "Each signatory & all parties listed above agree to hold the organizers of Dance Fiesta & their agents, heirs & assigns harmless from all suits, claims or demands of every kind & character arising out of & in conjunction with this event. We authorize the reproduction,sale,copyright,broadcast and/or distribution of all event still photography/videotape without limitation. We understand the physical risks of entering dance competitions & social dancing & assume full responsibility for any injury or personal damages resulting from Dance Fiesta. Competitors hereby consent to the collection & use of all data supplied on this form for tracking/publicizing event results. We certify that we are 18 years of age or older. Stipulations apply to Legal Guardian if applicant is under 18 years of age."
Date Date Male Signature Female Signature By After On Qty 2011 Dance Fiesta Registration 8/1/11 8/1/11 Site Total UCWDC Couples Classic Divisions Fiesta 'HOT' Pass *Best Value* Masters Open IV Diamond I Silver III Open Professional Open Syllabus A Diamond II Gold IV 3-Day Entrance to Ballrooms for all competitions & all dances, $140 $160 $175 All Workshops, Saturday Night FIESTA Dinner Show & Crown Open Syllabus B Diamond III Gold Comb Masters Competition, and Thursday Night Dance Party! Open I Crystal I Diamond IV Teen I/II Fiesta 'MILD' Event Pass Open II Crystal II Silver I Teen III Open III Crystal III Silver II Teen IV 3-Day Entrance to Ballrooms for all competitions & all dances, Youth Comb all "Free” Workshops! (All competitors, including Strictly, $85 $105 $120 Couples Showcase Divisions Youth IV must have at least this pass) Does Not Include: Dinner Show, Masters Diamond Primary Comb Pay Workshops, or Thursday Night Dance Party. Open Teen Primary IV Fri Fri Fri $30 $40 $50 Couples Dances 1-Day Event Pass Triple-Two Cha Cha East Coast Swing Sat Sat Sat Includes “Free” Workshops on that day and entrance into Polka Waltz West Coast Swing $30 $40 $50 ballrooms (excluding Dinner Show). Minimum pass needed Night Club Two-Step Solo Medley for all pay workshops. Under 12 years, half price. Sun Sun Sun $30 $40 $50 UCWDC Pro-Am & Pro-Pro Divisions Pro's Name Male Female Saturday Night Fiesta Dinner Show $45 $55 $60 Classic Open Newcomer Showcase Open with Masters Solos (includes dance after) Classic Crystal Novice Showcase Diamond Thursday Night Dance & Workshop $15 $15 $15 Classic Diamond Intermediate Showcase Teen Classic Silver Advanced Showcase youth Thursday Night Dance Only $10 $10 $10 Classic Gold Classic Teen Platinum Newcomer Pro-Am Spotlight Classic Youth Platinum Combined Friday Night Dance Only (Good after 6pm) $10 $10 $10 Classic Primary Pro-Pro Divisions: Open Classic Diamond Classic Saturday Night Dance (Good after Dinner Show) $10 $10 $10 Pro-Pro Spotlight Open Showcase Diamond Showcase
(Couples, Pro-Am, Line ) Pro-Am & Pro-Pro Dances $15 $18 $20 UCWDC Dance Fees Per Dance Triple-Two Cha Cha East Coast Swing Polka Waltz West Coast Swing Open 8 Dance & Teams $75 $75 $100 Night Club Two-Step Solo Medley UCWDC Line Dance Divisions WSDC Swing Jack-n-Jill $15 $15 $20 Classic Open Newcomer Showcase Open Classic Crystal Novice Showcase Diamond Two-Step Jack-n-Jill $10 $10 $10 Classic Diamond Intermediate Showcase Teen Classic Silver Advanced Showcase youth Strictly Swing & Hustle, Pro-Am Classic Gold Superstars $20 $25 $25 Classic Teen Rising Star Crown Jack-n-Jill, Swing, Hustle & Ntclub Classic Youth Renegade: Diamond Classic Primary Open Youth TOTAL DUE Line Dances Payment Information Rise & Fall (A) Duban (D) Solo Medley Lilt (B) Funky (E) Dance A Visa Mastercard Discover Smooth (C) Novelty (F) Dance B Choreography: Non-Country NC/Nov Country NC/Nov Credit Card # Exp ABC Non-Country Int/Adv Country Int/Adv Pro-Am Swing, Hustle & Nightclub CCV # (3-Digit Code on Back) : Check # Swing Pro Name Female Name Male Hustle Pro Name Signature Night-Club Pro Name Newcomer Novice Intermediate Advanced Make Checks Payable to: DANCE FIESTA Strictly Swing & Hustle Fax Registration to: (877)329-2354 Swing Novice Advanced Mail Registration to: 22534 E. Frost Place Hustle Intermediate Professional Aurora, CO 80016 Swing Partner Questions? Call or Email: (303)319-2716 [email protected] Hustle Partner Dinner Show Seating Request: Jack-N-Jills Swing Novice Intermediate Advanced NOTICE: Make selections carefully. There are no refunds. To get early bird discount, registration Two-Step Novice Intermediate Advanced must be submitted/postmarked by 8/1/11. No Exceptions. Pro-Am registration (except swing, nc, Pro-Am Novice Intermediate Advanced & hustle) must be received by 9/21/11. No Pro-Am registrations will accepted after this date! Get a Chance to Jack-N-Jill with the Pros!!