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Disclaimer
ON-LINE ENTRY FORM
THISTLE 'CITY OF BRISBANE' CHAMPIONSHIPS C6/2012
& COMPETITION SQC 12/01
Please use one official Entry Form per dancer.
Entry Fee - $25 Championship fee, $5 per dance plus $7 (per competitor, per day) Administration Fee
Cheques payable to Thistle Highland Dancing Studio Auxiliary.

ENTRIES CLOSE: Wednesday 7 March 2012

Email ThistleStudio@hotmail.com
NAME
PHONE NO
ADDRESS
 POSTCODE
REG. NO STUDIO
Age (as at date of competition) DOB
Saturday:
Championship Age Group
Events (numbers)
National Sections Events (numbers)
Cake Walk $5.00 entry fee per dancer - nominated partner
NB - PREMIER DANCERS WHO HAVE NOT PLACED 1ST, 2ND OR 3RD IN A CHAMPIONSHIP AND ARE ELIGIBLE FOR RESTRICTED PRIZE, PLEASE TICK
Sunday:
Section Classification
Events (numbers)
Thistle in the Round Title Events (numbers)
Pre-Championship Age Group
Events (numbers)
NB - BEGINNERS OR NOVICE DANCERS WITH SIX SQUARES MARKED, BUT COME WITHIN THE SIX MONTH RULE PLEASE TICK
Enclosed in envelope should be entry form, entry fee & administration fee $7.00 per day per dancer to be paid by cheque, postal note or cash for the amount of $

Entry form also accepted by Email ThistleStudio@hotmail.com
please forward a completed entry form for each dancer if paying by direct credit. Also, include dancers' name/s when depositing funds as reference.

Direct credit details for entry fees: Account Name: Thistle Highland Dancing Auxiliary
        Bank: CBA         B.S.B: 064-110          A/C: 00902126


I hereby agree that my child/I will abide by the rules of these Championships and Competition.