Dancer Registration Form

Name________________________________________________________________Please Print


Address_________________________________________________________________________


City:______________________________________State____________Zip Code_____________


Tribal Affiliation:____________________________Email Address_________________________


Phone Number:__________________________Cell / Work Number______________________


I will be dancing in competition for prize money.

Please check one of the following: Yes_____No_____

Adult Competition: Dancers 18 years of age and older

Junior Competition: Dancers 11 years of age to 17 years of age (proof of age may be required)

Category Entered (Please check only one)
Tiny Tots Girls (5 & under) ______

Tiny Tots Boys (5 & under) ______		 Womens Buckskin (18 & Up)______

Womens Cloth (18 & Up)__________
Youth Girls (6 - 10 Years)________

Youth Boys (6 - 10 Years)________		 Womens Fancy Shaw (18 & Up)______

Womens Jingle (18 & Up)__________
Junior Girls Traditional ( 11- 17)______

Junior Girls Fancy (11- 17)_______		 Mens Traditional (18 & Up)______

Mens Straight (18 & Up)__________
Junior Boys Traditional ( 11- 17)______

Junior Boys Fancy (11- 17)_______		 Mens Grass (18 & Up)______

Mens Fancy (18 & Up)__________
Womens Golden Age (50 & Up)______

Mens Golden Age (50 & Up)__________		  
I have read and understand the rules for competition

Signature_______________________________ Number Of Dancer__________