2014 AMERICAN MISS DANCE STATE ENTRY FORM
YES, I am planning to compete in the 2014 ( _______________ ) Miss Dance State Pageant®. I understand that this entire American Miss Dance® form and entry fees deadline is 2 months prior to my preliminary pageant. All packet information is mailed to the Home Office no later than 2 months before I compete. There will be NO late entries.
JUNIOR (7-12) TEEN (13-17) SENIOR (18-27)
First Name ____________________________ Last Name ____________________________
Middle Name ____________________________
Home Address ___________________________
City State________Zip ________________
Home Phone# Cell Phone#___________________________
Email Address* _____________________________________
(*must include for confirmation notice)
STATE RELEASE FORM
As parents/ guardian of a contestant in the (STATE) Miss Dance Pageant, I do hereby understand and agree that if my child wins the Overall Title, she must be allowed to advance to the National Pageant. The OVERALL Title holder MUST represent the state of ( ) at the National level or forfeit any future participating in the American Miss Dance pageant system. I do further agree to abide by the rules and regulations, directive and provisions for the winners and contestants are set forth in the Official American Miss Dance Rules and Regulations.
PLEASE READ, FAILURE TO COMPLY CAN RESULT IN LOSS OF POINTS OR DISQUALIFICATION
3 Age Divisions in all categories:
JUNIOR DIVISION
AVERAGE AGE: 7 - 12.99*
TEEN DIVISION
AVERAGE AGE: 13 - 17.99*
SENIOR DIVISION
AVERAGE AGE: 18 - 27.99*
MINIMUM COMPETITION AGE IS 7 YEARS
*AGE REQUIREMENTS
Age is determined by the dancer’s actual age as of the exact date of the competition.
GENERAL RULES
"Dance Studios, Dance Clubs and Dance Teams"
Large dance groups have the opportunity to register in a package deal.
All contestants must be registered along with their teachers for the entire pageant in the city where competing.
- No onsite competition entries will be accepted. Any changes must be made two weeks before the pageant , no exceptions.
- Pageant Tuition Fees and Hotel Fees must be submitted at the same time, but on two (2) separate checks or credit car. No Studio or Personal Checks Accepted After Cut-Off-Date.
- All routines must be appropriate for family viewing. Inappropriate routines will be stopped and/ or disqualified.
- No Teachers, Professional Dancers, Judges from different states of The American Miss Dance System Allowed to Compete at States or Nationals.
- General props OK, to be moved on and off stage by performers only. Must be moved on and off within 2 minutes or a 10 point deduction will apply. No Scenery, Dangerous, or Oversized props. No use of fire, glass or live animals on stage.
Where there is a safety concern, please speak to a AMD Associate when submitting your music. AMD reserves the right to disallow the use of any oversized or dangerous props.
No coaching from the audience
*TEACHERS, STUDIO OWNERS & MANAGERS
To qualify for the following, all participants must pre-register with you on the same registration form by registration cut-off-date
Pre-Registration Benefits:
Bring 5-15 full paying students, 1 teacher attends pageant free.
Bring 16-24 full paying students , assistant teachers or additional teachers; total of 2 teachers attend the pageant for free
Bring 25-29 full paying students, total of 2 teachers attend free and receive a American Miss Dance DVD of their choice (One DVD per studio)
30-80 full paying students, assistant teachers or additional teachers; total of 4 teachers attend free and receive a American Miss Dance DVD of there choice.
Teachers Registration includes:
*Special Studio Business Forum (Teachers Only)
*Free Admission to dance pageant
CODE OF CONDUCT
AMERICAN MISS DANCE, INC MANAGEMENT RESERVES THE RIGHT TO REFUSE ADMITTANCE TO, OR TO REMOVE ANYONE WHO IS DISRUPTIVE, UNRULY OR DISPLAYS RUDE, UNACCEPTABLE BEHAVIOR-TO BE DETERMINED AT DIRECTOR’S SOLE DISCRETION.
*CONFIRMATION EMAIL
A confirmation email will be sent to each Studio or Single Registrant upon receipt of tuition. PLEASE CHECK THIS EMAIL CAREFULLY. This email will allow you to confirm with our Pre-Registration Staff that your registration and competition entries are correct. If it is incorrect in any way, lease contact MONET at 614-526-8133. This email will also act as a receipt of payments made for your records. Bring a copy of your email to Pre-Registration desk between 7:00 a.m and 8:30 a.m on the first morning of the dance pageant when you pick up your Registration Packet.
*VIDEO RECORDING DEVICES & CAMERA EQUIPMENT PROHIBITED
Video recording devices are prohibited at the convention and competition. No camera equipment allowed in ballroom area or competition. Dangerous to audience. ( example: tripods ) Regular flash photos are allowed.
OFFICIAL SUPPLEMENT FORM TO BE MAILED IN WITH THE OFFICIAL ENTRY FORM!: NAME:________________________
AGE:_________________________
*Official American Miss Dance® T-Shirt size: please check one.
□adult X large
□adult large □adult medium
□adult small
□adult X small
□child small □child medium □child large
*PLEASE SEND A PHOTO OF YOURSELF TO BE PRINTED IN THE PROGRAM BOOK ( no larger than a 5x 7 please as they need to be reduced to go in the book)
$275.00 REQUIRED REGISTRATION FEE
$30.00 REQUIRED PHOTOGENIC FEE
$TOTAL REQUIRED FEES:
REQUIRED HOUSING PLAN
PLAN A ($210.00 Shared Room)
*Contestant’s name you are sharing with:
PLAN B ($250.00 Private Room)
$REQUIRED FEES:_________________________
HOUSING FEES:___________________________
FAMILY AND FRIENDS FEES:_________________
GRAND TOTAL OWED:______________________
FAMILY & FRIENDS !!
Please fill out the following form to order “meal tickets’ and/ or Door Passes for family and friends who are coming to support your AMD contestant.
*All Competition Events Pass:
*This Pass Gets You Into Every Event On Saturday And Sunday: Observer*
$20.00 EACH (Adults- age 13 & OVER)
$15.00 EACH ( ages 6-12) (ages 0-5 FREE
Total:
*Please order these with entry
AMERICAN MISS DANCE STATE FEES
REQUIRED FEES OF ALL PARTICIPANTS
$275.00 Registration Fee: Required of all participants. Includes registration fees for Opening number/ Improvisation, Out fit of Choice, Solo/ Talent, Formal wear/ Party dress, and official Pageant Jacket.
$30.00 Photogenic Fee: Required of all participants
REQUIRED HOUSING PLAN
PLAN A ($210.00 Shared Room)
*This plan is accommodations for two families consisting of two participants and two adults sharing a room with two double beds for two nights.
PLAN B ($250.00 Private Room)
*This plan if so a private accommodation for contestant and one adult for two nights
Note: ALL HOUSING IS TO BE BOOKED DIRECTLY THROUGH THE PAGEANT OFFICE, NOT HOTEL. YOU MUST INCLUDE ALL PAGEANT FEES AND ROOM EXPENSES AND MAIL THEM WITH YOUR ENTRY FORM TO:
AMERICAN MISS DANCE PAGEANT
5428 CROSS RIVER FALLS BLVD.
DUBLIN, OHIO 43016
*DEADLINE: Check the website
NO PERSONAL CHECKS. SEND MONEY ORDER OR CASHIER CHECLS OR WE ACCEPT VISA, MASTER CARD OR DISCOVER OVER THE PHONE.
MASTER OF CEREMONIES CARD
(FORMAL WEAR COMMENTARY)
First Name________________________
Last Name________________________
Middle Name________________________
Age_______
Hair Color ____________________________
Eye Color ________________________
Brothers________________________
Sisters________________________
Pets________________________
School________________________
Grade__________
Favorite Color________________________
Favorite Food ________________________
Favorite Broadway/ Musical________________________
Favorite Dance Icon______________________________________________
Favorite Team________________________
Ambition________________________
AWARDS & HONORS:________________________________________________________________________
________________________________________________
Please list scholastic/extracurricular achievements of which you are proud.
HOBBIES & INTERESTS:
________________________________________________________________________________________________________________________
MASTER OF CEREMONIES CARD
(Talent Introduction - Main Pageant)
Name:________________________
Age:___________________
Description of Talent:
________________________
Type of Dance:
________________________
Name of Song:
________________________
Accompaniment: ( ) CD ( ) CASSETTE TAPE ( ) OTHER
Microphone: ( ) HAND HELD ( ) ON STAND ( ) LAVALIERE
** Please email us at [email protected] for an informational packet on our local state division pageant! Get your dance studio involved by emailing us their information and AMD will send out pageant entry forms.
PRINT. FILL OUT. MAIL BACK.