PROMO DISCOUNT REGISTRATION

ACTIVATE YOUR ARTISTRY DANCE CONVENTION

PROMOTIONAL SCHOLARSHIP DISCOUNT REGISTRATION

2020-2021 SEASON
STUDIO/GROUP NAME *
INDEPENDENT DANCERS ENTER FIRST AND LAST NAME
NAME OF DIRECTOR

First Name Last Name
ADDRESS

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
PHONE NUMBER

Area Code Phone Number
EMAIL
example@example.com
REFERRAL NAME OR EVENT
If you were referred to Activate Your Artistry by an attending dancer or at an event, please include name in the box above.
SCHOLARSHIP REDEMPTION CODE
If applicable; code will be located on the bottom right corner of your award certificate. Award codes not required for studio or group registrations.
PLEASE SELECT THE REGIONAL DANCE CONVENTION ATTENDING *

CHICAGO, IL September 26-27, 2020 HOLIDAY INN ELK GROVE FORT WAYNE, IN November 21-22, 2020 RAMADA CONFERENCE CENTER FORT WAYNE DAVENPORT, IA December 12-13, 2020 VENUE TBD SOUTHERN IL/ST. LOUIS January 23-24, 2021 HOLIDAY INN ST. LOUIS DOWNTOWN
ROSTER

PLEASE ENTER ALL ATTENDEES. ENTER "X" IN THE APPROPRIATE LEVEL BOX NEXT TO EACH NAME. ADDITIONALLY PLEASE INDICATE WITH AN "X" IF THE DANCER IS ON A FULL OR HALF SCHOLARSHIP.

LEVEL CODES:

DIR. = DIRECTOR/TEACHER

PRIMARY = BEGINNER

PRE-PRO. = PRE-PROFESSIONAL/INTERMEDIATE LEVEL

PROF. = PROFESSIONAL/ADVANCED

FIRST NAME

LAST NAME

DIR.

PETITE

PRIMARY

PRE-PRO

PROF.

OBSERVER

HALF SCHOLARSHIP

FULL SCHOLARSHIP

10.

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PLEASE ENTER ANY ROUTINES YOU WOULD LIKE TO COMPETE IN THE CONCERT GALA.

ROUTINE TITLE

GROUP SIZE

ROUTINE LEVEL (Primary, Pre-Pro, Professional)

SOLOIST'S NAME (If Applicable)

CHOREOGRAPHER'S NAME

ENTRY #1

ENTRY #2

ENTRY #3

ENTRY #4

ENTRY #5

ENTRY #6

ENTRY #7

ENTRY #8

ENTRY #9

ENTRY #10

PLEASE UPLOAD YOUR CONCERT GALA MUSIC IN MP3 FORMAT. TITLES OF MP3'S PROVIDED SHOULD MATCH THE TITLES OF THE ROUTINES.

Browse Files

Cancel of

REGISTRATION - PLEASE ENTER THE NUMBER OF ATTENDEES FOR EACH LEVEL. DO NOT ADD FULL SCHOLARSHIP ATTENDEES TO TOTAL FEES DUE. CONCERT GALA ROUTINE TITLES AND MUSIC MUST BE EMAILED TO ACTIVATEYOURARTISTRY@GMAIL.COM NO LATER THAN 3 WEEKS BEFORE THE REGIONAL EVENT. **SCHOLARSHIP DISCOUNT CODES HAVE BEEN APPLIED TO PRICES LISTED BELOW**

NUMBER ATTENDING

TOTAL FEE DUE

DIRECTORS- COMP UP TO TWO DIRS.

PETITE - $50 (REG. $100)

PRIMARY - $100 (REG. $200)

PRE-PROFESSIONAL - $110 (REG. $225)

PROFESSIONAL - $115 (REG. $230)

SINGLE DAY PASS - $60 (REG. $125)

OBSERVER - $20 PER PERSON

CONCERT GALA SOLO - $20 PER ROUTINE

CONCERT GALA DUET - $20 PER ROUTINE

CONCERT GALA SM. GROUP - $30 PER ROUTINE

CONCERT GALA LG GROUP - $50 PER ROUTINE

GRAND TOTAL

REGISTRATION IS NOT GUARANTEED UNTIL PAYMENT IS RECEIVED. REGISTRATION WILL BE CLOSED WHEN MAXIMUM CAPACITY IS REACHED. THIS MAY BE BEFORE CUT-OFF DATE.
IF PAYMENT IS RECEIVED AFTER CUT-OFF DATE THERE IS A $50 LATE FEE ADDED TO
THE REGISTRATION.
PAYMENT METHOD

VISA MASTERCARD DISCOVER AMERICAN EXPRESS CHECK MONEY ORDER PLEASE SEND INVOICE TO BE PAID NO PAYMENT/FULL SCHOLARSHIP
IF PAYING BY CHECK OR MONEY ORDER, PLEASE MAIL TO ACTIVATE YOUR ARTISTRY,1259 OLDE FARM ROAD, SUITE 102, SCHAUMBURG, IL 60173 POSTMARKED BY THE CUT OFF DATE.

REGISTRATION FEE PAYMENT

USD TOTAL REGISTRATION FEE DUE

CARD INFORMATION
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Postal Code

SIGNATURE REQUIRED: I have read and understand all of the Activate Your Artistry rules and regulations. This signature releases Activate Your Artistry, ownership, all employees,teachers and staff from any liability for any contracts, claims, liabilities, suits, actions, illnesses including COVID-19 or damages of any kind regarding injuries or damages from any participation in Activate Your Artistry Convention. I understand that all footage from attending may be used for publicity including video, voice and photography. I understand that all registration fees are non-refundable if the planned event is held. Credits or refunds for missing an event will be given by ownership on a case by case basis.Please use mouse to sign electronically. *

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REGISTRATION NOTE (IF APPLICABLE)
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