DANDRIDGE SCOTS-IRISH FESTIVAL

Saturday, Sept. 25,  2010

Highland Dance Entry Form

FUSTA USSE-0429

                  Please enter me in the events listed below.  I hereby, for myself, my heirs, executors, and administrators, waive and release any and all rights to claims I may have for damages against Dandridge Scots-Irish Festival, their agents or representatives, for any injuries I may suffer during said Dandridge Scots-Irish Festival.   I further agree to accept and to act according to the rules of the Scottish Official Board of Highland Dancing and of these games.

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Signature of entrant if aged 18 years or over, of parent or guardian if under 18

Name (please print)__________________________________________________________

Address___________________________________________________________________

City_____________________________ State__________________ Zip_______________

Telephone  (_____) ___________________________

Email _____________________________@_______________________

Class____________________________________    Age_______________________

Dances entered______________________________________________________________

__________________________________________________________________________

Age as of Sept. 25, 2010_____________      Date of Birth____________________________

Registration number____________________________________________________

Amount of check attached   $_______________

All Highland Dance contestants will receive complementary admission.. Age will be reckoned as of the day of competition, Sept. 25, 2010, and proof may be required.  Age group will be determined by the number of entries received.