A.S.D.
world
DanceSport
federation
THE STAR CHAMPIONSHIP
Olga Cacciari & Simone Canè
32° Trofeo Vittorio Colombo
MODULO DI ISCRIZIONE - ENTRY FORM
Trasmettere a: Fabio Temperini - Fax +39 0861 1850582 - E-mail: [email protected] entro le ore 18 del 15/03/2013
Please, send to: Fabio Temperini - Fax +39 0861 1850582 - E-mail: [email protected] within 6 p.m. 15/03/2013
Si prega di scrivere in stampatello / Please, write in block letters
Cav./Man_____________________________________________________________________________________________________________________________________________
Cognome/Nome - Surname/Name
Dama/Lady__________________________________________________________________________________________________________________________________________
Cognome/Nome - Surname/Name
Nazione/Country______________________________________________________ E-mail__________________________________________________________________
PLEASE TICK EVENTS YOU WISH TO ENTER
WDSF Rising Star Amateur Standard
(escluse le prime 50 coppie in ranking list WDSF)
Senior II “Classe A” Latini
22th Mar.
Senior III “Classe A” Standard
(solo coppie classe A/NO AS)
Senior IV “Classe A2” Standard
(solo coppie classe A2/NO A1)
Amatori “Classe A2” Standard
(solo coppie classe A2/NO A1)
WDSF Senior III Standard
Senior V Standard “Classe A”
(solo coppie 66 e over)
WDSF Senior II Latin
Senior IV Standard “Classe A” (A2+A1)
Senior I “Classe A” Latini
Youth “Classe A” Standard
WDSF Professional Division Open Latin
(solo coppie classe A/NO AS)
Senior II “Classe A” Standard
WDSF Senior II Standard
WDSF Senior I Latin
Youth “Classe A” Latin
(solo coppie classe A/NO AS)
Senior I “Classe A” Standard
24th Mar.
(escluse le prime 50 coppie in ranking list WDSF)
Amatori “Classe A2” Latin
(solo coppie classe A2/NO A1)
23th Mar.
WDSF Rising Star Amateur Latin
WDSF Senior I Standard
WDSF Juveniles 6/11 Latin
WDSF Juveniles 6/11 Standard
(over 35)
WDSF World Open Latin
WDSF Youth Standard
WDSF Professional Division Open Standard
WDSF Junior 12/15 Latin
WDSF Junior 12/15 Standard
WDSF Professional Division Open Standard
(over 35)
WDSF World Open Standard
WDSF Youth Latin
WDSF Professional Division Open Latin
QUOTE DI ISCRIZIONE A COPPIA / ADVANCE ENTRY FEES PER COUPLE
Quota unica a coppia per gara classe A, gara WDSF e Professional Division: E 50,00 (only quota)
MODALITA’ DI PAGAMENTO / METHODS OF PAYMENT
- Bollettino di C/C postale n. 1001222528 intestato a “CANE’ SIMONE”. Causale: “32° Trofeo V. Colombo”
oppure / or
- Bonifico bancario IBAN: IT39O0760102400001001222528. Int.: Canè Simone
(Allegare la ricevuta di versamento)