Registration Form
After filling the details click on the SUBMIT button.
*
indicates required fields
*
Full Name:
*
Postal Address:
*
Phone Number:
*
Email Address:
Registration Number (if known):
Juvenile:
$30
Junior:
$30
Youth/Adult/Master:
$60
Professional Unqualified:
$70
Professional Qualified:
$65
Adjudicator Licence:
0.00
Affiliated (non Dancer, non Professional):
$15
Amateur Artistic Dancer:
$15
Pro/Am Amateur Registration:
$10
Levels/Grades as at the end of last year:
*
I agree to the Disclaimer/Privacy Statement:
I have read and agree to the Disclaimer/Privacy Statement
*
I agree to abide by NZBDC Rules:
I have read and agree to abide by the NZBDC Rules
*
Is this a new Registration:
Yes
No
If this is a new Registration, what is your DOB?:
Paid by Cheque to P O Box 301317, Albany 0752:
posted
Paid by DC to 06-0266-0177831-01:
deposited
*
Date of Birth:
Additional Comment:
Main Teacher:
After filling the details click on the SUBMIT button.
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