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REGISTRATION FORM - TAP CHALLENGECOMPETITOR
JA's Philly TAP Challenge "ON FIRE!"
June 15, 2009
Arts Bank Theater
320 South Broad Street (Broad & South sts)
Philadelphia, PA. 19147

FINAL MAIL-IN DEADLINE IS June 15, 2009


First Name: *
Last Name: *
Address: *
 
City: *
State: *
Postal Code: *
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Payment Method:
Check
534 S. 56th Street, 1st Floor Rear Philadelphia, PA 19143

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  Fees
Per Person Fees are $10. for All Group(s) or soloists.

The Tap Challenge Fee includes the Competition Fee and a ticket to the Theater.

Submit Money Order To: LEJA
534 south 56th Street - 1st fl
Philadelphia, PA. 19143
(215) 747-5352

NO REFUNDS


Name of Challenge Performer:

Enter your age:

Name of Song / Music:

Choreographer:

Time:

Name of School (if applicable)

Judging is based on the decision of the audience. All decisions will be final. In case of a tie, the final decision will be made by the professional dance community that is present. Philly Tap Challenge wants to show off the best feet we can find. Violations of any rules will result in immediate disqualification.

I hereby agree that I am participating in the Philly Tap Challenge of my own free will and will abide by all rules and regulations relating to the event. I hereby release LEJA,PCBC the directors, their agents, servants and any employees of the Philly Tap Challenge and the Iron Gate Theater upon which the event is being conducted, from all claims for damages including but not limited to loss of property, accident or injury during or in connection with the said event. I have read and understand this agreement; my signature indicates my agreement to be bound by the above.


Signed (Parent or legal Guardian if under 18 yrs. of age)


   
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