WISCONSIN STATE PRO/AM ACCOUNTING AND ENTRY FORM

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WISCONSIN STATE PRO/AM ACCOUNTING AND ENTRY FORM STUDENT TEACHER NDCA # PACKAGE E ME A MA B MB C NON Double Single No Hotel Name of Roommate: NON-PACKAGE TICKETS Wednesday Thursday Thursday Friday Friday urday urday Sunday ACCOUNTING Package Price $ Non-Package Tickets $ # Freestyles $ # Solo Exh. $ # Solo Scholar $ # Championships $ # Scholarships $ TOTAL $ SOLO EXHIBITIONS LEVEL _ STYLES _ DANCE _ LEVEL _ STYLES _ DANCE _ AMERICAN FREESTYLE ENTRIES AGE LEVEL W T F VW CH RU SW BO MA SA ME HSTL SAL WCS ARG PO JIT NC2 PB **Please clearly mark proficiency entries! INTERNATIONAL FREESTYLE ENTRIES AGE LEVEL W T VW F QS CH SA RU PD JV CLOSED CHAMPIONSHIPS (A1, A2, B1, B2, C1, C2, D) OPEN CHAMPIONSHIPS (A, B, C) SCHOLARSHIPS (A, B, C & Sr.) Novice A & B AGE LEVEL STYLE AGE LEVEL STYLE

WISCONSIN STATE AMATEUR ACCOUNTING AND ENTRY FORM MAN LADY PHONE PACKAGE E ME A MA B MB C NON Double Single No Hotel Name of Roommate: NON-PACKAGE TICKETS Wednesday Thursday Thursday Friday Friday urday urday Sunday ACCOUNTING Package Price $ Non-Package Tickets $ # Freestyles $ # Solo Exh. $ # Solo Scholar $ # Championships $ # Scholarships $ TOTAL $ SOLO EXHIBITIONS LEVEL _ STYLES _ DANCE _ LEVEL _ STYLES _ DANCE _ AMERICAN FREESTYLE ENTRIES AGE LEVEL W T F VW CH RU SW BO MA SA ME HSTL SAL WCS ARG PO JIT NC2 PB INTERNATIONAL FREESTYLE ENTRIES AGE LEVEL W T VW F QS CH SA RU PD JV CLOSED CHAMPIONSHIPS (A, B, C, D) OPEN CHAMPIONSHIPS (A, B, C) SCHOLARSHIPS - All Ages/Levels Combined AGE LEVEL STYLE AGE LEVEL STYLE

WSDC ACCOUNTING SUMMARY Duplicate form if needed Studio Name: Contact Person: Contact Phone: Email Address: PACKAGES enter information below Name Package Cost of Entries Total Per Person Non package and spectator tickets - see other side Non-package competitor hotel rooms: $167.00 plus tax ($192.22). We book the room, You pay the hotel directly upon the completion of your stay. Credit card type: _ Expiration Date: Special requests? Send forms and payment by March 23, 2018 to: WSDC 1323 E. Conway Street, Milwaukee, WI 53207 Any questions? Call: MARTIN 414-807-6321 or Email: wsdcmke@yahoo.com

NON PACKAGE AND SPECTATOR TICKETS Name Wed Thurs Thurs $30 Fri Fri $40 Din/ Show $120 1st Row $60 2nd Row $55 Res. Floor $50 Gen Admin SRO $50 Sun Adult $20 Sun PT/JR Youth $10 Cost of Entries Total Per Person Packages Total Due: Non Package or Spectator Tickets Total Due: _ Grand Total: _

WISCONSIN STATE PROFESSIONAL ACCOUNTING AND ENTRY FORM MAN LADY NDCA # CITY CONTACT PHONE EMAIL _ PACKAGE E ME A MA B MB C NON Double Single No Hotel Name of Roommate: NON-PACKAGE TICKETS Thursday *Pro/Pro Tickets are Friday complimentary for urday each session you are competing in. Sunday ACCOUNTING Package Price $ # Rising Star $ # OPEN $ # Showdance $ TOTAL $ SHOWDANCE STYLE: DANCE RISING STAR SOCIAL SECURITY # AMERICAN SMOOTH MAN - - AMERICAN RHYTHM INTERNATIONAL STANDARD LADY - - INTERNATIONAL LATIN OPEN AMERICAN SMOOTH AMERICAN RHYTHM INTERNATIONAL STANDARD INTERNATIONAL LATIN

WISCONSIN STATE RELEASE FORM Pro Dance, Inc, the organizers of the WSDC, the Pfister Hotel and the National Dance Council of America (NDCA) cannot be held liable for injury sustained by any person attending this event. The attendee assumes all responsibility for injuries or any actions that may occur as a result of attending the Wisconsin State Dancesport Championships. ryone who attends does so at their own risk. No responsibility for loss of theft of articles left in changing rooms, ballroom, or anywhere else within the hotel can be accepted by The Wisconsin State Dancesport Championships or its organizers. All persons attending this event, whether as a spectator, competitor, official, or guest of the organizers, shall be bound by the NDCA rules. EVERYONE desiring to attend this event MUST sign this form. Professionals must include their Social Security or Federal ID number. This form must be completed and returned with your entry forms. THIS FORM MUST BE COMPLETED AND RETURNED WITH YOUR ENTRY FORMS. Full Name (all Competitors) Soc. Sec. # (Professionals) NDCA # Signature