Merengue and Cha Cha Cha Competion

Application Form for Couples

Saturday 18 April 2009

 

Deadline for entries, including payment, is Saturday 11 April 2008

 

Partner 1

 

Firstname:

 

Surname:

 

Address:

 

 

Postcode:

 

Tel No:

 

Mobile:

 

e-mail:

 

Signature:

 

Date:

 

Partner 2

 

Firstname:

 

Surname:

 

Address:

 

 

Postcode:

 

Tel No:

 

Mobile:

 

e-mail:

 

Signature:

 

Date:

 

 

Please tick your selections:

 

We are entering the Merengue Competition:

 

 

 

We are entering the Cha Cha Cha Competition:

 

 

Championship Entry Fee: (Includes entry into event)

 


£24 for Merengue and £24 for Cha Cha Cha per couple                       Enclosed

 

Please make cheques payable to Salsanorthwest and send to: 1 Kingsbridge Close, Penwortham, Preston, PR1 9UR

 


We agree to adhere to the rules and regulations as published on the Salsanorthwest site

 

Note: All dancers must sign a waiver form on the evening