2018 Peach State Country and Western Dance Festival

2018 Peach State Country and Western Dance Festival

Complete this form and enclose payment. Your passes will be waiting upon arrival. If you wish a confirmation either include a self-addressed, stamped envelope or provide your e-mail address ______. There are NO REFUNDS.

Male’s Name:Female’s Name:

Address:Address:

City, State: Zip City, State: Zip

Phone or E-mail:Phone or E-mail:

Submission of this form by the party or parties listed above signifies the following statement: “We agree to hold the organizers of this event and their agents 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, sales, copyright, exhibition, broadcast, and/or distribution of any event videotape without limitation. We understand the physical risks of entering dance competition and social dancing and assume full responsibility for any injury or personal damages resulting from the event named above. We certify that we are 18 years or older (applicable to Legal Guardian if under 18 years of age).”

SignatureDateSignatureDate

Competition Information
All Competitors Must Purchase a 3-Day Pass / Spectator & / or Competitor Event Fees
Couples – Classic / Dances / QTY / On or
Before
Feb 28 / On or
After
Mar 1st / Total
Masters
Crown Classic /  Silver I
 Silver II / Triple Two
Open I
Open II /  Silver III
 Silver IV / Polka / 3-Day Pass / _____@ / $69.00 / $80.00 / ______
Open III /  Gold I/II / Night Club / ***Best Value!!***
Open IV
Open Social /  Gold III / Cha-Cha / Includes Nightly dances in Country, Swing
and Line Dance Ballrooms, Saturday Night
Crystal I /  Gold IV / Waltz / Variety Show & Workshops designated (fr)
Crystal II
Crystal III
Open Syllabus
Jr Syllabus
(Circle Below) /  Primary I/II / Two-Step
 Primary III
 Primary IV
 Primary Social
 Youth I/II / East Coast
West Coast / Juniors 7-16 3-Day Pass / _____@ / $30.00 / $35.00 / ______
A B C D /  Youth III
 Youth IV / Solo-Medley
Show Dance / Video Pass / _____@ / $15.00 / $15.00 / ______
 Diamond I
 Diamond II /  Youth Social
 Teen I/II / Friday Pass (starts 9:00 a.m.) / _____@ / $28.00 / $35.00 / _____
 Diamond III
 Diamond IV / Teen III
 Teen IV
 Teen Social / Friday Competitions, Friday Night Dances
and Workshops designated (fr)
Couples-Showcase / Dances / Saturday Pass
All Competitions, Open Dancing,
Free (fr) Classes & Saturday Night Show
Saturday Night Pass (starts 7:00 p.m.)
Includes Variety Show &All Dance Rooms
Masters
Crown Showcase / Triple Two
Polka / Two Step
East Coast / _____@ / $40.00 / $45.00 / ______
Open / Night Club / West Coast
Diamond / Cha-Cha / Solo Medley / _____@ / $20.00 2 2 2 2 212 .00 / $25.00 / ______
Showcase Teen / Waltz / 
Pro-Am Swing & Hustle (Sunday) / Sunday Pass
Competitions, Open Dancing, Awards / _____@ / $20.00 / $25.00 / ______
Amateur’s Level / Age Division / Dance(s) / Ceremony and Workshops designated (fr)
Novice / Junior (17 & under) / Swing
Intermediate / Open (All ages) / Hustle / Workshop Ticket Books (10 tickets) / _____@ / $40.00 / $45.00 / ______
Advanced / Sophisticated (35+)
Masters (50+) / UCWDC Dance Fundamentals Class / _____@ / $25.00 / $25.00 / ______
Weekend or Sunday pass required. / Two 2 hour classes $25 each
See Friday Schedule
Pro’s Name:
Line Dance Competitors / Competitors Only
Male / Female / Couples per Dance / _____@ / $20.00 / $24.00 / ______
Division (Classic) / Level / Dances / Line Dancers per Dance / _____@ / $20.00 / $24.00 / ______
Open (18+) / Newcomer / Rise & Fall / Scores (UCWDC Divisions only) / Free / Free / ______
Crystal (30+) / Novice / Pulse / Pro-Am Swing / _____@ / $20.00 / $25.00 / ______
Diamond (40+) / Intermediate / Smooth / Pro-Am Hustle / _____@ / $20.00 / $25.00 / ______
Silver (50+)
Gold (60+) / Advanced / Cuban
Street / TOTAL / $______
Teen (14-17)
Youth (10-13)
Primary (up to 9) /  Social (new) (Junior, Silver & Open only) / Stage / Male Associate Member # ______
Female Associate Member # ______
Rising Star
Super Star
Crown / For Showcase Line Dance registration forms contact Bill Robinson @ 678-640-4633. / ALL TEAM DIVISIONS WILL BE OFFERED!

For team registration forms call Bill Robinson 678-640-4633

Or email at

Enclose a check for total amount payable to Peach StateDance Festival, and mail to 293 Prestwick Drive, Hoschton, GA 30548

For info call Bill Robinson (cell) 678-640-4633 or e-mail or call Pat Perkins at 404-273-8087.

2018 Peach State Country and Western Dance Festival

Pro-Am Entry Form Except Sunday Pro-Am Swing & Hustle

Complete this form and enclose payment. Your tickets will be waiting upon arrival. If you wish a confirmation either include a self-addressed stamped envelope or provide your e-mail address ______. There are NO REFUNDS.

Male Competitor’s Name:Female Competitor’s Name:

Address:Address:

City, State: Zip City, State: Zip

Phone or E-mail:Phone or E-mail:

Female Pro’s Name:Male Pro’s Name:

Phone or E-mail: Phone or E-mail:

2nd Female Pro’s Name (if applicable) 2nd Male Pro’s Name (if applicable)

Phone or E-mail:Phone or E-mail:

Competitor’s SignatureDateCompetitor’s SignatureDate

Competition Information
All Competitors Must Purchase a 3-Day Pass / Pro-Am Event Fees
All Pro-Am sign up except Swing & Hustle closes Mar. 6th

PRO-AM Registration, (except Swing and Hustle), must be received by

Tuesday March 6, 2018 by mail or online.

/ QTY / On or Before
Feb 28 / On or After
March 1 / Total
Male Student / Female Student / 3-Day Pass / _____@ / $69.00 / $80.00 / ______

Division

Level

Dances

/ ***Best Value!!***
Classic: / Nightly dances in Country, Swing and
Open / Social (Open &Juniors only) / Classic / Line Dance Ballrooms, includes
Saturday Night Variety Show &
Crystal / Newcomer / Triple Two / Workshops designated (fr)
Diamond
Silver / Novice
Intermediate / Polka
Night Club
Gold / Advanced / Cha Cha / Juniors 7-16 3-Day Pass / _____@ / $30.00 / $35.00 / ______
Teen / Int/Adv comb. / Waltz
Youth / Pro-Pro I / Two Step
Primary / Pro-Pro II / East Coast / Workshop Ticket Books (10 tickets) / _____@ / $40.00 / $45.00 / ______
Platinum / Pro-Pro Spot. / West Coast / For Workshops designated “(pd)”
Open Syllabus
Jr Syllabus / Pro-Am Spot. / See Friday Schedule
(circle below)
A B C D /

Note: In Syllabus Divisions

there are no Overall Awards / Sat. & Sun. Workshop Schedules
on Web Site closer to Event
Showcase Open / Showcase Pro-Pro / Showcase / Pro-Am per Dance / _____@ / $20.00 / $24.00 / ______
Showcase Dia. / Spotlight Junior / Triple Two / Scores / _____@ / Free / Free / ______
Showcase Teen / Spotlight Silver / Polka
Showcase Youth / Night Club / Sub Total / $______
Spotlight Open / Cha -Cha / Total from other side if any / $______
If you are entering more than one Pro-Am Div. or with more than one Pro, please attach a note to this form for clarification.
Pro-Am Int/Adv awards Friday night.
Pro-Am New/Nov awards Saturday night. / Waltz / TOTAL / $______
Two Step
East Coast
West Coast / Male Associate Member # (required) ______
Female Associate Member # (required) ______

Pro-Am Swing & Hustle Registration on other side of this form. Competition will be held on Sunday March 18th