A.S.D.
world
DanceSport
federation
THE STAR CHAMPIONSHIP
Olga Cacciari & Simone Canè
34° 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 02/03/2015
Please, send to: Fabio Temperini - Fax +39 0861 1850582 - E-mail: [email protected] within 6 p.m. 02/03/2015
Si prega di scrivere in stampatello / Please, write in block letters
Cav./Man_____________________________________________________________________________________________________________________________________________
Cognome/Nome - Surname/Name
MIN
Dama/Lady__________________________________________________________________________________________________________________________________________
Cognome/Nome - Surname/Name
MIN
Nazione/Country______________________________________________________ E-mail__________________________________________________________________
PLEASE TICK EVENTS YOU WISH TO ENTER
13th Mar.
14th Mar.
Amatori “A Class” Standard
WDSF Rising Star Amateur Latin
Amatori “A Class” Latin
WDSF Senior II Latin
Senior III “A Class” Standard
WDSF Senior III Standard
Senior IV “A Class” Standard
WDSF Senior IV Standard
WDSF Rising Star Amateur Standard
Senior II “A Class” Latin
(escluse le prime 50 coppie in ranking list)
Senior II “A Class” Standard
WDSF PD Master Class I Open Latin (over 35)
Senior I “A Class” Latin
WDSF International Open Latin
Youth “A Class” Latin
WDSF Senior II Standard
WDSF Senior I Latin
WDSF Under 21 Standard
WDSF Youth Latin
WDSF PD Adults Standard (over 18)
Senior I “A Class” Standard
WDSF Youth Standard
Youth “A Class” Standard
WDSF PD Master Class I Open Standard (over 35)
WDSF Senior I Standard
15th Mar.
(escluse le prime 50 coppie in ranking list)
WDSF Juveniles 6/11 Latin
WDSF Juveniles 6/11 Standard
WDSF PD Master Class II Open Standard (over 45)
WDSF International Open Standard
WDSF Junior 12/15 Latin
WDSF Under 21 Latin
WDSF Junior 12/15 Standard
WDSF PD Adults Latin (over 18)
QUOTE DI ISCRIZIONE A COPPIA - ADVANCE ENTRY FEES PER COUPLE
Quota unica a coppia per 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: “34° Trofeo V. Colombo”
oppure / or
Bonifico bancario IBAN: IT39O0760102400001001222528 - CODICE BIC/SWIFT: BPPIITRRXXX CIN: O - Int.: Canè Simone
Allegare la ricevuta di versamento - Attach your receipt of payment