PHDA Winter 2025 Competition Registration

PHDA Winter 2025 Competition Registration

FUSTA ID #USNW - 0309
This is the single-competition entry form for the Portland Highland Dancing Association's Winter 2025 Indoor Competition. Please do not use this entry form if you jave signed up for a 2024-25 season membership. The competition will be held at Valley Community Presbyterian Church.

Registration closes January 11, 2025.

**Late entries are being accepted with double the entry fee until Tuesday, January 21, 2025 **

No entries will be accepted after January 21, 2025.

Contact Information for Member
Name (Parent/Guardian/Adult Dancer):*

First NameLast Name
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
Email Address (all membership & competition updates will be sent via email)*
example@example.com

Acknowledgements and Releases
Membership (must be signed by parent/legal guardian if entrant is not 18 years of age): I hereby make application for membership in the Portland Highland Dancing Association (PHDA) for the period of January 1, 2025, to February 28, 2025. I have read and understand the rules and regulations on this form. I hereby for myself, my heirs, executors and administrators waive and release any and all rights and claims I may have for damages against the Portland Highland Dancing Association, their agents or representatives, successors and assignees, for any and all injuries or illness suffered by me at or through the above mentioned events.*

I have read the above notice and agree to the terms of membership described
Waiver (must be signed by parent/legal guardian if entrant is not 18 years of age): I hereby, for myself, my heirs, executors and administrators, waive and release any and all rights and claims for damages I/we may have against the Portland Highland Dancing Association or Valley Community Presbyterian Church, their agents, representatives, successors and assignees, for any and all injuries suffered by me/us through the above mentioned Dance Association.*

I have read the above notice and agree to the terms of the waiver described
Dance Competition Rules (must be signed by parent/legal guardian if entrant is not 18 years of age): I/We have read and understand the rules and regulations for the Portland Highland Dancing Association's dance competition being held on January 25, 2025. I/We understand that abiding by these rules is a requirement of participation for all members and competitors.*

I have read the above notice and agree to the terms of the dance competition rules described
Photo/Likeness Release (must be completed by parent/legal guardian if entrant is not 18 years of age): I/we give permission to have myself and/or my child/children photographed for print, video, and/or electronic imaging. I/we understand that images may be used in promotional materials, news releases, and/or other published formats. I/we acknowledge the images will be the sole property of the Portland Highland Dancing Association.*

I have read the above notice and agree to the terms of the photo/likeness release describedI would prefer not to have myself and/or my child/children photographed for print, video, and/or electronic imaging
Parent/Guardian/Adult Dancer Signature (must be at least 18 years of age)*

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Sponsorships & Donations
Dance and membership fees alone do not cover all competition costs. To help defray the costs of the rentals, fees, supplies, and awards, please consider being a sponsor or donating to the Portland Highland Dancing Association. As a not-for-profit organization, PHDS is happy to provide you with a donation receipt for tax purposes, and you will also be recognized in the competition program. Thank you for supporting the future of Highland Dancing in the Portland Metro area!
I would like to donate the following amount to be used where most needed:
Donation Amount

Payment
Total PHDA Membership + ScotDance USA Fees:*
Total Entry Fees:*
Sub-Total:*
If you have any questions regarding your registration please email the competition secretary at portlandhighlanddance@gmail.com. Once you click "Proceed to Checkout" you will be taken to PayPal for secure payment. Your registration will not be submitted until payment is completed.
Total Amount Due:

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PHDA Winter 2025 Competition Registration

Contact Information for Member

Dancer Information

Dancer #2

Dancer #3

Dancer #4

Acknowledgements and Releases

Volunteer Sign-up

Sponsorships & Donations

Payment