VMJC2019 Registration event registration

First Name *

Last Name *

Address *

City *

Postcode *

Country *

State *

Mobile *

Email *

Ticket Type (Select One) *

Down for everything! $155 Early Bird ($180 full price after 22nd Feb). Early Birds also get your choice of 2 free spectator tix or a VMJC drink bottle!

I can't come to everything so will choose the one event I can attend. ($90 to compete in 1 Saturday event only)

Spectators and other events - I just wanna come watch (and maybe dance a little), but no competing for me.

I'm a Judge - no really, I am :)

Choose the Event(s) that you are competing in.

Note: If you are in multiple events, you must choose the "Down For Everything" option above. *

Not competing

Freestyle

DWAS

Over 40s

Lucky Dip

Follower Blind

Cabaret

Team

Freestyle Level (Your personal level, not the level you are dancing at as a couple in this comp) *

Freestyle Partner *

Freestyle Dance Role (Lead or Follow) *

DWAS Dance Role (Lead or Follow) *

DWAS Level *

Lucky Dip Dance Role (Lead or Follow) *

Lucky Dip Mix n Match
How many years have you been dancing Modern Jive? *

Over 40s Dance Role (Lead or Follow) *

Over 40s Partner *

Follower Blind Dance Role (Lead or Follow) *

Follower Blind Partner *

Cabaret Name *

Cabaret Partner *

Team Name(s) *

Team Organisation(s) *

Team Partner(s) *

Team Organisation

Are you the team manager? *

Who is the team manager? *

Your Dance Experience *

Which dance company are you representing? *

Other - Company representing

Your Current Modern Jive Teacher *

Friday Night Dance Party Tix ($25 for locals)

Spectator Tickets ($25 before April 15th, $33 after)

Group Spectator Tickets ($22 fo 5+)

Saturday Night Party Tickets ($33)

Sunday Workshops ($65 includes Tea Dance)

Sunday Tea Dance ($22)

Are there any conflicts that may stop you from judging any particular section eg: life partner in a particular section? *

Coupon

Amount

$

Discount Amount

$

Payment processing fee

$

Gross amount

$

Payment Method

Paypal

Billing Postcode*

Credit Card Number*

Expiration Date*

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Card (CVV) Code*

Card Type*

Card Holder Name*

By registering for this event, I accept Terms and Conditions

Individual Registration

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