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USA Dance, Royal Palm Chapter # 6016 - Sponsor/ Organizer of the Royal Palm Dancesport Competition

2018 Royal Palm Dancesport Competition

Parent/ Guardian Consent & Release Form

Required From a Parent or Guardian of Each Competitor Under 19 Years Old

 
Upon submitting this Form, you will receive an e-mail with registration instructions and a link to our O2cm online Registration Form, where you (or the person entering your minor child in the Competition) can sign in and register your child and his/her partner for the Royal Palm Dancesport Competition. Please coordinate so that only one Registration Form is submitted per couple.

If Your child is dancing in a Youth or Younger Amateur Couple:

A Parent or Guardian for each partner under 19 must submit this Form. You can do this together (preferable) or separately. Fill in the names of both partners in the Couple, and all information for the Parent(s) or Guardian(s) signing and submitting this Form and for your own child or children. Select "Amateur Couple" under Type of Couple, Click the Box to Accept the Terms of the Consent & Release (required), in the Signature Blank at the bottom, type in the full name(s) of all Parent(s) or Guardian(s) signing and submitting this Form (separated by commas), and then click the red "Send" button at the bottom to submit this Form.

If your child is dancing in a Teacher/Student Couple:

Complete the portions of this form applicable to you and your child below, select "Teacher/ Student" under Type of Couple, and fill in the name, telephone and e-mail address of the Teacher. Click the Box to Accept the Terms of the Consent & Release (required), Type your full name in the Signature Blank at the bottom (required), and click the red "Send" button at the bottom to submit this Form.

Parent or Guardian for Minor Gentleman:

Name of Minor Gentleman Competitor (age 18 or younger) (required)

Parent or Guardian's Name (required)

Parent/ Guardian's Email (required)

Parent/ Guardian's Telephone Number (required)

Parent/ Guardian's Address (all lines required):


Minor Gentleman's USA Dance (or Affiliated Organization) Membership Number & Expiration Date

USA Dance Chapter of which Minor Gentleman is a member (if applicable):

Parent or Guardian for Minor Lady:

Name of Minor Lady Competitor (age 18 or younger) (required)

Parent/ Guardian's Name (required)

Parent/ Guardian's Email (required)

Parent/ Guardian's Telephone Number (required)

Parent/ Guardian's Address (all lines required):


Minor Lady's USA Dance (or Affiliated Organization) Membership Number & Expiration Date

USA Dance Chapter of which Minor Lady is a member (if applicable):

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Type of Couple in which your Child is Dancing: (required)
 Amateur Couple Teacher/ Student Couple

If you clicked "Teacher/ Student Couple" above, please enter the name, telephone number and e-mail address of the Teacher with whom your child is dancing (required for Teacher/ Student Couples):

Terms, Consent & Release (required of Parent/Guardian of all Competitors under Age 19):
Please read, Click the Box to Accept the following Terms, Consent & Release Form (required of Parent or Guardian for all Competitors under Age 19), type your name(s) as Parent or Guardian (separated by commas) in the Signature Blank below, and then Click "SEND" below to submit your Parent/ Guardian Consent & Release Form.

- Check the Box to Accept the Terms, Consent & Release (required). By submitting this Parent/Guardian Consent & Release Form and/or by registering my child, or allowing my child to register, for the Royal Palm Dancesport Competition, each Parent or Guardian identified above hereby represents and agrees as follows:

1. Payment of Competitor Package/ Entry Fees Due. I agree that, on behalf of my child, I will complete, or cause to be completed, Steps 5 and 6 of the O2cm form to add the applicable Competitor Package due for each dancer in the couple, and immediately use, or cause to be used, the "Pay Now" button found at the bottom of the O2cm Registration Form to pay in full the Competitor Package fees and Entry Fees applicable for the entries made, via PayPal or Credit Card. I understand that Registration is not complete until the Competition Organizer receives full payment of all Competitor Package fees & Entry Fees due for the couple, as well as the Registration Form.

2. Consent & Release Accepted and Agreed: I hereby consent to my child identified above participating as a Competitor (in the couple identified above) in the Royal Palm Dancesport Competition (the "Competition"). I have read, understand, and agree that my child will abide by the USA Dance DanceSport Rulebook, as and to the extent applied at the Competition, and the Rules, Regulations and Guidelines for this Competition, as set forth on www.RoyalPalmDancesport.org. I represent and warrant that my child is eligible to enter all events for which my child has registered or will register and that my child will not register for an event below his or her minimum proficiency level in each category or in an Age Category not permitted under the USA Dance Dancesport Rulebook. I understand that all athletes may be subject to drug testing by the WDSF or USA Dance, and if I my child is an Amateur Athlete Member of USA Dance, I understand that if he or she violates the Dancesport Rules of USA Dance, as applied at this Competition, his/her Amateur Athlete competitor status with USA Dance may be suspended. I understand that the competition may be filmed/videoed/photographed and I agree that the organizers may use any images or videos of my child captured at the Competition, and/or the name of my child, for promotional or other purposes related to the Competition, now or in the future. I consent to receiving, and to my child receiving, e-mails or communications from the organizers, now or in the future (from which we may unsubscribe after the Competition, if we so choose). I understand and agree that no responsibility for bodily injury or for loss or theft of articles left in the changing rooms, competition venue, practice room, seating areas or elsewhere by persons attending or participating in this event, can or will be accepted by the organizers, USA Dance, Inc., the Royal Palm Chapter of USA Dance, Goldcoast Ballroom, any of their respective officers, directors, agents or representatives, or any hotel, and, for myself and on behalf of my minor child identified above, I hereby release, hold harmless, and agree to indemnify all of the foregoing persons & entities from any and all claims or liabilities of any kind arising in connection with my child's participation in or his/her or my attendance at the Competition. I understand and agree that everyone attending the Competition does so at his or her own risk.

Please be sure you have filled in all applicable blanks above which are marked "(required)" and have checked all required boxes, including the box to Accept the Terms, Consent & Release.

To Submit Your Parent/ Guardian Consent & Release Form:

Step 1:   Type the full names of each Parent or Guardian signing and submitting this Form (separated by commas) in the Signature Blank below, and Click the Red "SEND" button below to Submit this Form. You should then see a message outlined in green on your screen below, saying, "Your Parent/ Guardian Consent & Release Form Form was submitted successfully."

Step 2:   Watch your E-mail. You will receive an e-mail with instructions and a link to the O2cm Registration Form, where you can Register your child for the Competition and pay the applicable Competitor Registration Package and Entry Fees. Your child's Registration will not be complete until we receive both the Registration Form and your payment. (If your child has already been registered, or will be registered by his/her Teacher or a Parent or Guardian of his/her amateur partner, you can ignore the e-mail you will receive, and skip this Step 2. You are done. Please coordinate, so that no more than one Registration Form is submitted for each couple competing.)

Signatures: (required - this form will not submit without typed in signatures)

Thank you for your interest in our 2018 Royal Palm Dancesport Competition!

We look forward to seeing you and your children at the Competition on Saturday, January 20, 2018!!

If someone else will register your child for the Competition, you can ignore the e-mail that will be sent to you with a link to Registration.

If you are responsible for registering your minor child for the Competition, please watch your e-mail. You will receive an e-mail with instructions and a link to our O2cm Registration Form, where you can register your child and his/her partner for the Competition. If you do not receive the e-mail with link to our O2cm Registration Form within a few minutes, please check your Spam folder, and if not there, or if you have any questions, please e-mail us at: RPC@royalpalmdancesport.org.

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The Annual USA Dance Royal Palm DanceSport Competition - now in it's 15th year -
is one of the most highly regarded dancesport competitions in Florida and in the United States.
We welcome amateur competitor couples from around the United States, Canada, and the world!
Starting in 2018, we will also include Teacher/ Student and Pro/Am Events!

Competition Sponsors & Principal Donors: