HisName_____________________________________________________ HerName_____________________________________________________

Address______________________________________________________ Address______________________________________________________

City_________________________State_________Zip_________________ City_________________________State_________Zip_________________

E-mail________________________________________________________ E-mail________________________________________________________

Phone____________________________UCWDC#____________________ Phone____________________________UCWDC#____________________

MaleSignature_______________________________Date___________________FemaleSignature_________________________________Date___________________

HisDOB_________________ HerDOB_________________ ☐ NightClub ☐ Newcomer ☐ Intermediate☐ Hustle ☐ Novice ☐ Advanced

CLASSICDIVISIONS SHOWCASEDIVISIONS ☐ WestCoastSwing ☐ Masters☐ TwoStep

☐ Masters ☐ SilverI ☐ Masters ☐ Diamond☐ OpenI ☐ SilverII ☐ OpenI ☐ Teen☐ OpenII ☐ SilverIII LeaderName______________________________________________☐ OPENIII ☐ SilverIV Crown☐ OpenIV ☐ GoldII/I ☐ CrownShowcase ☐ CrownClassic☐ OpenSyllabusA ☐ GoldIII ☐ CrownPlusShowcase ☐ CrownPlusClassic FollowerName____________________________________________☐ OpenSyllabusB ☐ GoldIV☐ CrystalI ☐ TeenCombined DANCES☐ CrystaII ☐ TeenNewcomer ☐ TripleTwo ☐ Waltz☐ CrystaIII ☐ YouthCombined ☐ Polka ☐ TwoStep☐ DiamondI ☐ YouthNewcomer ☐ NightClub ☐ EastCoastSwing☐ DiamondII ☐ PrimaryCombined ☐ ChaCha ☐ WestCoastSwing EVENTPASSES Before03/18 After03/18 Total☐ DiamondIII ☐ PrimaryNewcomer ☐ Showdance ☐ SoloMedley☐ DiamondIV ☐ SyllabusABCD WeekendPass $115 $135

(Circle) IncludesWorkshops

DayPass $60 $70IncludesWorkshops

☐ MaleStudent ☐ FemaleStudent DOB____________________DanceOnlyPass $20 $20

CLASSICDIVISION LEVEL Friday&Saturdayafter9pm☐ Open ☐ Platinum ☐ SyllabusA ☐ Newcomer☐ Crystal ☐ SilverIII ☐ SyllabusB ☐ Novice ThursdayNightDance $10 $10☐ Diamond ☐ Teen ☐ SyllabusC ☐ Intermediate FreetoWeekendPassHolders☐ Silver ☐ Youth ☐ SyllabusD ☐ Advanced (Startsat7pm)☐ Gold ☐ Primary ☐ Int/AdvCombined

SHOWCASEDIVISION PROPRO DANCEFEES(perDance)☐ Open ☐ Teen ☐ OpenClassicI ☐ DiamondClassicI☐ Daimond ☐ Youth ☐ OpenClassicII ☐ DiamondClassicII UCWDCCouples,Line&ProAm $16 $21

☐ OpenShowcase ☐ DiamondShowcase Quantity___________________

UCWDCDANCES Showtime/UCWDCTeams $30 $35☐ TripleTwo ☐ Polka ☐ NightClub ☐ ChaCha Quantity___________________☐ Waltz ☐ TwoStep ☐ EastCoastSwing ☐ WestCoastSwing

ContemporaryPro-Am $16 $21Pro#1__________________________________________UCWDC#___________________ Quantity___________________

Pro#2__________________________________________UCWDC#___________________

ProcessingFee $5 $5 $5

TOTAL☐ MaleStudent ☐ FemaleStudent DOB____________________

CLASSICDIVISION LEVEL☐ Open ☐ Gold ☐ Newcomer ☐ Crown☐ Crystal ☐ Teen ☐ Novice ☐ Risingstar☐ Diamond ☐ Youth ☐ Intermediate ☐ Superstars☐ Silver ☐ Primary ☐ Advanced

MailRegistrationto:SHOWCASEDIVISION UCWDCDANCES SanDiegoDanceFesival MakeChecksPayableto:☐ Open ☐ Ris&Fall ☐ Stage c/oCarmen&MarnieMattei SANDIEGODANCEFESTIVAL☐ Diamond ☐ Pulse ☐ DanceA 16044S15thDr.☐ Teen ☐ Smooth ☐ DanceB Phoenix,AZ85045

☐ Cuban ☐ SoloMedley☐ SOCIALDivision:123(circle) ☐ Street

Togetearlybirddiscount,registrationmustbepostmarked/receivedbyMarch10,2018.THEREARENOREFUNDS-Pleasefilloutformcarefully.

UCWDCCOUPLESDIVISIONS

UCWDCPROAMPROPRODIVISIONS

UCWDCLINEDANCEDIVISIONS

2019SANDIEGODANCEFESTIVAL

Submission of this form stipulates the following: “Each signatory and all parties listed above agree to hold the organizers of this event and their agents, heirs and assigns harmless from all suits, claims or demands of every kind and character arising out of and in conjunction with this event. We hereby authorize the reproduction, sale, copyright, exhibition, broadcast and/or distribution of any event still photography or videotape without limitation. We understand the physical risks of entering dance competitions and social dancing and assume full responsibility for any injury or personal damages resulting from the event named above. Competitors hereby consent to the UCWDC exclusive collection and use of all data supplied on this form for tracking and publicizing our event results and agree to receive news about UCWDC standings and activities. We certify that we are 18 years of age or older. Stipulations apply to Legal Guardian if applicant is under 18 years of age.”

CONTEMPORARYPRO-AM

Note:AllUCWDCcompetitorsmusthaveAssoiateMembership

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