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P.O. BOX 1195 • MCMINNVILLE, OR 97128
WWW.FIERCECONVENTION.COM FIERCECONVENTION@HOTMAIL.COM
FIERCE
THE ULTIMATE DANCE CONVENTION
REGISTER NOW FOR 2010
Please Check One:
[ ] THE BILLINGS MONTANA EXPERIENCE, JULY 24 AND 25
BEGINNING/INTERMEDIATE LEVEL (Suggested Ages 8-12)
INTERMEDIATE/ADVANCED LEVEL (Suggested Ages 13 and up)
Convention Tuition: $200.00 per dancer, per event
Includes: Eight (8) workshop classes.
Bonus: Free studio showcase
Dancer Registration: $200.00 per dancer, per event
Note: Duplicate this form for additional registrants.
Studio Name ____________________________________________
Teacher ____________________________________________
Studio Phone ( _____ ) ____________________________________
Address ____________________________________________
City, State, Zip ____________________________________________
E-mail ____________________________________________
Name Age Level
1. _____________________________________________ ________ _______________________
2. _____________________________________________ ________ _______________________
3. _____________________________________________ ________ _______________________
4. _____________________________________________ ________ _______________________
5. _____________________________________________ ________ _______________________
6. _____________________________________________ ________ _______________________
7. _____________________________________________ ________ _______________________
8. _____________________________________________ ________ _______________________
9. _____________________________________________ ________ _______________________
10. _____________________________________________ ________ _______________________
TOTAL DANCERS FEES ENCLOSED $___________________
Please include a studio check or money order.
TEACHERS ATTENDING______________________________________________________
_______________________________________________________
_______________________________________________________
P.O. BOX 1195 • MCMINNVILLE, OR 97128
WWW.FIERCECONVENTION.COM FIERCECONVENTION@HOTMAIL.COM
FIERCE
THE ULTIMATE DANCE CONVENTION
Observers Registration Form 2010
Observer Fee: $50.00 per person, per event
Includes: Two days of observation of all classes
Bonus: Free studio showcase.
Note: Duplicate this form for additional registrants.
Studio Name ____________________________________________
Teacher ____________________________________________
Studio Phone ( _____ ) ____________________________________
Address ____________________________________________
City, State, Zip ____________________________________________
E-mail ____________________________________________
Name
1. _____________________________________________
2. _____________________________________________
3. _____________________________________________
4. _____________________________________________
5. _____________________________________________
6. _____________________________________________
7. _____________________________________________
8. _____________________________________________
9. _____________________________________________
10. _____________________________________________
TOTAL OBSERVERS FEES ENCLOSED $ _______________
Please include a studio check or money order.
P.O. BOX 1195 • MCMINNVILLE, OR 97128
WWW.FIERCECONVENTION.COM FIERCECONVENTION@HOTMAIL.COM
FIERCE
THE ULTIMATE DANCE CONVENTION
STUDIO SHOWCASE REGISTRATION 2010
Up to 7 routines per studio.
1. Routine Name ____________________________ Dance Style ___________
Please Circle - Solo Duo Trio Group
2. Routine Name ____________________________ Dance Style ___________
Please Circle - Solo Duo Trio Group
3. Routine Name ____________________________ Dance Style ___________
Please Circle - Solo Duo Trio Group
4. Routine Name ____________________________ Dance Style ___________
Please Circle - Solo Duo Trio Group
5. Routine Name ____________________________ Dance Style ___________
Please Circle - Solo Duo Trio Group
6. Routine Name ____________________________ Dance Style ___________
Please Circle - Solo Duo Trio Group
7. Routine Name ____________________________ Dance Style ___________
Please Circle - Solo Duo Trio Group
P.O. BOX 1195 • MCMINNVILLE, OR 97128
WWW.FIERCECONVENTION.COM FIERCECONVENTION@HOTMAIL.COM
FIERCE
THE ULTIMATE DANCE CONVENTION
Waiver & Release Form 2010
WAIVER AND RELEASE
I hereby waive all claims for injury, damage or loss to my person and property during my participation and
release the promoters, directors, principals, agents and employees of Fierce Productions and Convention
from any liability for injury, damage or loss which may be caused by any act or omission of any of them.
I understand that the purpose of FIERCE Productions and Conventions is to provide quality dance
workshops and studio showcase dance opportunities. Photographs, taping or filming of participants by any
and all FIERCE Productions and Convention Staff members, agents or members of the press become the
property of FIERCE Productions and Convention and may be used for future promo use. By signing, each
of the registered participants in FIERCE Productions and Convention each dancer, parent or studio owner
expressly adopts and agrees to be bound by the above waiver and release agreement. The signature of a
parent/guardian, studio director/owner, or teacher is required in the case of every participant who is under
18 years of age (participants 18 years of age and over must sign for themselves).
Studio directors/owners or teachers may sign for their students.
The proper signing of this agreement on this form is a condition of participation in the event.
PLEASE FILL OUT:
Studio Name ____________________________________________
Director ____________________________________________
Address ____________________________________________
City, State, Zip ____________________________________________
Studio Phone ( _____ ) ____________________________________
Director’s Signature _______________________________________
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