Contemporary solo Registration

Note** If not paying with PayPal please read the instructions at the bottom of the page.

 
 
Date *
Date
Division *
Name of Dancer *
Name of Dancer
Gender of Dancer *
Date of Birth of Dancer *
Date of Birth of Dancer
Phone Number of Dancer *
Phone Number of Dancer
Address of Dancer *
Address of Dancer
Name of Coach *
Name of Coach
Phone Number of Coach *
Phone Number of Coach
Copy the link to your Headshot below ( The file name must be the name of the dancer ) *The photo must be black and white * For security purposes, please email a photo of your passport or official ID to the following: vkibc.registrar@gmail.com Any applications submitted without proof of ID will not be accepted or reviewed.
Note* The length of the music can not exceed 4 minutes. Note** Please put : Name of Composer, Name of the Song in the field below.
Note* The length of the music can not exceed 4 minutes. Note** Please put : Name of Composer, Name of the Song in the field below.
Emergency Contact Name *
Emergency Contact Name
Emergency Contact Phone Number *
Emergency Contact Phone Number
*Electronic Signature is considered a binding official signature.*
*Electronic Signature is considered a binding official signature.*
I have read and understood the VKIBC rules and regulations including the liability waiver *
Payment Method *
Note** This form will not be submitted nor will be valid unless payment is made. If paying with PayPal please go to the bottom of the page and select the payment. If paying with US. Check please mail to ( VKDC the Studio 509 Westport Avenue 06851 Norwalk C.T ) If paying with Wire Transfer please read the info at the bottom of the page.
How did you hear about VKIBC ? *

If paying with PayPal please click add to cart and then preceded to Checkout

Contemporary Solo Division 1, 2 , 3 , 4
300.00
Quantity:
Add To Cart
 

Wire transfer info ~

( the Dancer must pay the Transfer fee if the fee is not paid your payment will not be accepted )

NOTE** IF YOU DO NOT PAY THE TRANSFER FEE WE WILL NOT REIMBURSE YOU & YOUR REGISTRATION WILL NOT BE ACCEPTED.

  1. Chase Bank

  2. Swift code : chasus33

  3. account Number : 757910133

  4. Routing Number : 021000021

  5. Bank Address : 270 Park ave NYC, ny, usa 10017