* 2012 Platinum DanceSport Classic *

PRO/AM & STUDENT/STUDENT AMERICAN STYLE ENTRY FORM

Dances for each division are as follows:
A Newcomer Waltz, Tango, Foxtrot, V Waltz, Cha-cha, Rumba, Swing, Bolero, Mambo, Merengue, Hustle, Salsa, WCS, Arg Tango B Pre-Bronze Waltz, Tango, Foxtrot, V Waltz, Cha-cha, Rumba, Swing, Bolero, Mambo, Merengue, Hustle, Salsa, WCS, Arg Tango C Int Bronze Waltz, Tango, Foxtrot, V Waltz, Cha-cha, Rumba, Swing, Bolero, Mambo, Merengue, Hustle, Salsa, WCS, Arg Tango D Full Bronze Waltz, Tango, Foxtrot, V Waltz, Cha-cha, Rumba, Swing, Bolero, Mambo, Merengue, Hustle, Salsa, WCS, Arg Tango E Pre-Silver Waltz, Tango, Foxtrot, V Waltz, Cha-cha, Rumba, Swing, Bolero, Mambo, Merengue, Hustle, Salsa, WCS, Arg Tango F Int Silver Waltz, Tango, Foxtrot, V Waltz, Cha-cha, Rumba, Swing, Bolero, Mambo, Merengue, Hustle, Salsa, WCS, Arg Tango G Full Silver Waltz, Tango, Foxtrot, V Waltz, Cha-cha, Rumba, Swing, Bolero, Mambo, Merengue, Hustle, Salsa, WCS, Arg Tango H Pre-Gold Waltz, Tango, Foxtrot, V Waltz, Cha-cha, Rumba, Swing, Bolero, Mambo, Merengue, Hustle, Salsa, WCS, Arg Tango J Int Gold Waltz, Tango, Foxtrot, V Waltz, Cha-cha, Rumba, Swing, Bolero, Mambo, Merengue, Hustle, Salsa, WCS, Arg Tango K Full Gold Waltz, Tango, Foxtrot, V Waltz, Cha-cha, Rumba, Swing, Bolero, Mambo, Merengue, Hustle, Salsa, WCS, Arg Tango L Open Bronze Waltz, Tango, Foxtrot, V Waltz, Cha-cha, Rumba, Swing, Bolero, Mambo, Merengue, Hustle, Salsa, WCS, Arg Tango M Open Silver Waltz, Tango, Foxtrot, V Waltz, Cha-cha, Rumba, Swing, Bolero, Mambo, Merengue, Hustle, Salsa, WCS, Arg Tango N Open Gold Waltz, Tango, Foxtrot, V Waltz, Cha-cha, Rumba, Swing, Bolero, Mambo, Merengue, Hustle, Salsa, WCS, Arg Tango O Gold Star I Waltz, Tango, Foxtrot, V Waltz, Cha-cha, Rumba, Swing, Bolero, Mambo, Merengue, Hustle, Salsa, WCS, Arg Tango P Gold Star II Waltz, Tango, Foxtrot, V Waltz, Cha-cha, Rumba, Swing, Bolero, Mambo, Merengue, Hustle, Salsa, WCS, Arg Tango Q Closed 3-Dance Bronze Championship (A, B or C) * ** Waltz/Tango/Foxtrot, Cha-cha/Rumba/Swing R Closed 4-Dance Silver Championship (A, B or C) * ** Waltz/Tango/Foxtrot/V Waltz, Cha-cha/Rumba/Swing/Bolero S Closed 4-Dance Gold Championship (A, B or C) * ** Waltz/Tango/Foxtrot/V Waltz, Cha-cha/Rumba/Swing/Bolero T - DVIDA 3-Dance Syllabus Scholarship (16+) * Waltz/Tango/Foxtrot, Cha-cha/Rumba/East Coast Swing U Closed 4-Dance Scholarship (A, B, or C) * ** Waltz/Tango/Foxtrot/V Waltz, Cha-cha/Rumba/Swing/Bolero V Open Youth 4-Dance Championship (Ages 12-18) * Waltz/Tango/Foxtrot/V Waltz, Cha-cha/Rumba/Swing/Mambo W Open Senior 3-Dance Championship (Ages 65+) * Waltz/Tango/Foxtrot, Cha-cha/Rumba/Swing X WPDS Open 4/5-Dance Championship (A, B, or C) * ** *** Waltz/Tango/Foxtrot/V Waltz, Cha-cha/Rumba/Swing/Bolero/Mambo Y Open 4/5-Dance Scholarship (A, B or C) * ** Waltz/Tango/Foxtrot/V Waltz, Cha-Cha/Rumba/Swing/Bolero/Mambo

Ages:

Pre-Teen (11 & Under) Junior 2 (14-15) Junior 1 (12-13) Youth (16-18)

A1 (19-35) A2 (36-50)

B1 (51-60) B2 (61-70)

C1 (71-80) C2 (81+)

Other: * ** ***

Dancers must enter an equal number of single dances in order to enter multi-dance events. Ladies and gentlemen will be combined for all multi-dance events. Age categories are as follows: A (19-35) B (36-50) C (51+) World Pro/Am DanceSport Series qualifier. Participation in the WPDS is not necessary to enter.

Professional Studio Professionals Address City

Student Division

Phone # State
Age Gender W T F V C R

NDCA# Email

SS# Zip Code

SW B M ME H SA WCS AT

* Deadline: January 23, 2012 * Please send complete entries (entry form, waiver, accounting form & check or money order payable to Platinum DanceSport Classic) to: Platinum DanceSport Classic, 1914 Haverhill Road, Baltimore, Maryland 21234. Telephone (410) 825-5483. FAX (410) 665-4252. Entries will not be processed without payment in full. Incomplete entries or entries received after January 23, 2012 will be accepted at the discretion of the organizers if space & time permit. Page One

* 2012 Platinum DanceSport Classic *

PRO/AM & STUDENT/STUDENT AMERICAN STYLE ENTRY FORM Professional (or Student/Student Man) Student (or Student/Student Lady)
Single Entries @ $ ($35 Package A-E Holders, $40 Non-Package Holders, $15 Pre-Teen & Junior, $25 Youth) Closed 3-Dance Championships @ $ ($75 Package A-E Holders, $85 Non-Package Holders) Closed 4-Dance Championships @ $ ($85 Package A-E Holders, $95 Non-Package Holders) DVIDA 3-Dance Syllabus Scholarships @ $ ($75 Package A-E Holders, $85 Non-Package Holders) = $

= = =

$ $ $ $ $ $ $ $ $

Closed 4-Dance Scholarships @ $ = ($95 Package A-E Holders, $105 Non-Package Holders) Senior 3-Dance Championships @ $ ($75 Package A-E Holders, $85 Non-Package Holders) Youth 4-Dance Championships @ $ ($85 Package A-E Holders, $95 Non-Package Holders) = =

Open 4/5-Dance Championships @ $ = ($95 Package A-E Holders, $105 Non-Package Holders) Open 4/5-Dance Scholarships @ $ = ($105 Package A-E Holders, $115 Non-Package Holders) TOTAL =

WAIVER
All persons attending the Platinum DanceSport Classic (spectators, competitors, officials, staff, guests, etc.) shall be bound by the rules and regulations of the National Dance Council of America (NDCA) and Platinum DanceSport Classic. The organizers, NDCA and hotel can accept no responsibility for loss or theft of articles left in the changing rooms, ballroom, guest rooms or hotel. Neither can they be held liable for injury sustained by persons attending the Platinum DanceSport Classic. Everyone does so at his or her own risk and expressly and irrevocably waves any claim or claims arising from any loss or injury incurred at this event. In addition, this event may be photographed and recorded by television, video, photography or other method. All persons attending this event, by their presence, may be photographed, videotaped or broadcasted and waive any claim related to the use of their image, their rights of any copyright, privacy or publicity and consent to the use, exhibition, transmission, distribution or sale of such images by Platinum DanceSport Classic, its organizers, employees, vendors and representatives in any type of media throughout the world without limitations.

Signature (Guardian, if Minor)

Printed Name

Date

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