Performing Arts Competition Studio Summary Form

Mail Completed Summary Form, Entry Forms and full payment to: P O Box 183 Elkin, NC  28621

336-527-4898winfo@dancemachineonline.comw FAX: 336-527-4762 wwww.dancemachineonline.com

Circle or highlight the competition city your studio or school is attending

Columbia, SC March 14/15                   Roanoke, VA March 21/22        Raleigh, NC April 4/5

Myrtle Beach, SC April 25/26               Charlotte, NC May 2/3               Lenoir, NC May 9

Studio/School Name ______________________________________________

Mailing Address __________________________________________________

City____________________________ State _________ Zip _______________

Phone (_____) ______ - _______ E-mail ______________________________

Studio Director __________________________________________________

Solos                          _________ x $65.00 =           $______________

Duets                          _________ x $72.00 =            $______________

Trios                           _________ x $108.00 =          $______________

Photogenic                _________ x $25.00 =            $______________

Groups  ($22.00 per dancer per group)  Total of Group Routines   $____________

TOTAL ENTRY FEES $________________

How many individual group dancers do you have performing in group routines, count each dancer one time,

not for each routine they are in.

#of individual group Performers ___________    

Choose below if you want medals for each group dancer or you wish to donate $3.00 per dancer to one of the charities below. 

q MEDALS                  q March of Dimes                   q Shriners Children’s Hospital

ALL ENTRIES MUST BE RECEIVED AND PAID IN FULL 21 DAYS BEFORE THE COMPETITION DATE! Late entries are subject to a $20.00 late fee

and space available. All competitions are limited in size. All rules and guidelines are on the website: www.dancemachineonline.com