List of partecipant _ Choreography 1. 2. 3.

n. name surname birthday email

N.B. In case of more than 15 dancers, please copy the page and continue the list.

For registration of 2 or 3 choreographies, please copy the page and submit a list for group

composition for each choreograph.

Title choreography 1 _____________________________________________ time, min. _____ sec. _____

Choreographer ____________________________________________________ N° dancers _________

- Title choreography 2 _____________________________________________ time, min. _____ sec. ____

Choreographer ____________________________________________________ N° dancers _________

- Title choreography 3 _____________________________________________ time, min. _____ sec. ____

Choreographer _____________________________________________________ N° dancers _________

Note __________________________________________________________________________________

__________________________________________________________________________________

With this registration form, the above group or soloist, it forwards the request to participate in the

INTERNATIONAL DANCE SHOWCASE of Mediterranean Dance Festival 2012 Program:

LAB 1 July 9 LAB 2 July 16 LAB 3 July 23 LAB 4 July 29

I declare that Calabria Arte Association It’s exempted from all civil and penal responsibility concerning and

consequent to the participation in the event. It’s dismissed from all responsibility regarding the physical

suitability of all participants and possible accidents.

I declare to be a member of Calabria Arte Association to accept all the terms and conditions of participation

and have presented for all members of the group membership documentation, self-certification of physical

health, release use image and permission of the parent to participate in the event.

Place and date ________________________________________

Signature Group-leader / Soloist Stamp (not mandatory)

______________________________________________

Дата добавления: 2015-11-14