North West Open Amateur Salsa Championships

The Official North West Open Amateur Salsa and Bachata Championships

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 North West Open Amateur SALSA Championships:

We are entering the North West Open Amateur BACHATA Championships:

Championship Entry Fee: (Includes entry into event)

£24 for Salsa and £24 for Bachata 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

Salsanorthwest, 1 Kingsbridge Close, Penwortham, Preston, PR1 9UR Tel 01772 752081 Mob 07899866408

E-mail: phil@salsanorthwest.co.uk