Transcript the star championship - The World Dance Plaza

A.S.D.
world
DanceSport
federation
THE STAR CHAMPIONSHIP
Olga Cacciari & Simone Canè
35° Trofeo Vittorio Colombo
MODULO DI ISCRIZIONE - ENTRY FORM
Trasmettere a: Fabio Temperini - Fax +39 0861 1850582 - E-mail: [email protected] entro le ore 18 del 29/02/2016
Please, send to: Fabio Temperini - Fax +39 0861 1850582 - E-mail: [email protected] within 6 p.m. 29/02/2016
Si prega di scrivere in stampatello / Please, write in block letters
Cav./Man_____________________________________________________________________________________________________________________________________________
Cognome/Nome - Surname/Name
MIN
Dama/Lady__________________________________________________________________________________________________________________________________________
Cognome/Nome - Surname/Name
MIN
Nazione/Country______________________________________________________ E-mail__________________________________________________________________
PLEASE TICK EVENTS YOU WISH TO ENTER
11th Mar.
12th Mar.
13th Mar.
(escluse le prime 50
coppie in ranking list)
Amatori “A Class” Standard
Amatori “A Class” Latin
Senior III “A Class” Standard
Senior III bis “A Class” Standard
Senior IV “A Class” Standard
Senior II “A Class” Latin
WDSF Rising Star Amateur Standard
WDSF Senior IV Standard
WDSF Senior II Latin
WDSF Rising Star Amateur Latin
WDSF Senior III Standard
Senior V “A Class” Standard
Senior I “A Class” Standard
WDSF PD Master Class II Open Latin
Youth “A Class” Standard
WDSF Youth Standard
WDSF Senior I Standard
WDSF PD Master Class I Open Latin
WDSF World Open Standard
(over 35)
WDSF Under 21 Latin
WDSF PD Master Class II Open Standard
(over 45)
WDSF PD Adults Latin (over 18)
Senior II “A Class” Standard
WDSF Senior II Standard
Senior I “A Class” Latin
Youth “A Class” Latin
WDSF Senior I Latin
WDSF PD Master Class I Open Standard
WDSF Juveniles 6/11 Latin
WDSF Youth Latin
WDSF Juveniles 6/11 Standard
WDSF World Open Latin
WDSF Junior 12/15 Latin
WDSF Under 21 Standard
WDSF Junior 12/15 Standard
WDSF PD Adults Standard (over 18)
(escluse le prime 50
coppie in ranking list)
(over 45)
(over 35)
QUOTE DI ISCRIZIONE A COPPIA - ADVANCE ENTRY FEES PER COUPLE
Quota unica a coppia per gara WDSF e Professional Division: E 50,00 (only quota)
MODALITA’ DI PAGAMENTO - METHODS OF PAYMENT
Bollettino di C/C postale n. 1030812422 intestato a “Impariamo a ballare s.r.l.” - Causale: “35° Trofeo V. Colombo”
oppure / or
Bonifico bancario IBAN: IT59Z0760102400001030812422 - CODICE BIC/SWIFT: BPPIITRRXXX CIN: Z
Int.: “Impariamo a ballare s.r.l.”
Allegare la ricevuta di versamento - Attach your receipt of payment