Unofficial Registration Indonesia Championship Preliminaries

DANCER (LEADER)

First Name (LEADER)

Last Name (LEADER)

Date of Birth

ID or Passport

Country of Birth

Country of Residence

City of Residence

Phone Number

Email Address

I HAVE HAD A WORK, PROFESSIONAL OR PERSONAL RELATIONSHIP WITH ANY OF THE MEMBERS OF THE JURY FROM THE COMPETITION, IN THE LAST 6 MONTHS PRIOR TO THE CHAMPIONSHIP

Work

Personal

Professional (For example: I've taken classes with a jury member)

None

Categories You will Dance

Valz

Milonga

Senior

Your Signature

AGREE

All the information provided at the time of check-in will be considered a sworn statement

DANCER (FOLLOWER)

First Name (FOLLOWER)

Last Name (FOLLOWER)