Fun in the Sun
THEATRE ON ICE Competition
OFFICIAL TEAM ENTRY FORM for - Adult, Open,thNovice, Junior & Senior
Closing date for entries: Monday 13 June, 2016
THEATRE ON ICE FREE PROGRAM EVENT ENTERED - Please mark with X in applicable box -
Adult
Open
Novice
Junior
Senior
Team Details:
Team Name:
Name of Coach/es:
Name of Team Manager/s:
Contact Person:
Email:
Phone:
Mobile:
Club:
State:
ENTRY FEES – Adult, Novice, Junior and Senior
Number of members
ENTRY FEES
TEAM ENTRY FEE
Number of 15m blocks
Cost per skater
TOTAL
@ $20.00
$
$ 55.00
$
$
$
Cost per 15mins
WED PRACTICE ICE
@ $50
Official DVD if wanted - Team only $50 / Division $75
TOTAL
$
Payments are to be sent to the Treasurer Kyle Perry, PO Box 4467, Forest Lake. 4078 or banked directly into QSIC’s bank account.
Suncorp / BSB: 484-799 / Account number: 043971585 / Account name: Queensland Synchronized Iceskating Club / Entry Fees – Team
name/s. Send the confirmation of payment with Entries to Convenor: Tricia Marcovich, [email protected]
Competitor Agreement:
1.
2.
3.
4.
5.
I/We confirm that I / we meet the eligibility specified in the published ISA Rules and the Rules for this event.
I/We agree to abide by the rules of this event, ISQ Inc. and ISA Incorporated.
I/We agree to be punctual for draws, practices, events and official ceremonies.
I/We agree to assume all risks of injury or loss for myself / ourselves or, if a parent/guardian, on behalf of my child /
ward, and do hereby release and in all respects discharge and agree to hold harmless the conducting body, its officers,
agents, employees and sponsors from any claim arising from injury or loss from participation in this event.
I/We agree to being videotaped for the Official fundraising DVD.
Signature of Team Manager / Club Official:
Name of Team Manager/ Club Official signing this form:
Date:
Fun in the Sun
THEATRE ON ICE Competition
OFFICIAL TEAM ENTRY FORM for - Adult, Open, Novice, Junior & Senior
28th
,
August
2010
Part 2 of 4
Event / Division:
Name of Team :
TITLE OF PERFORMANCE
ISA Rule 1210
PROGRAM DESCRIPTION - Written description
The official competition program should contain a written description of the performance ONLY,
which must be provided by the team at the time of application to the competition as part of the
competition announcement. The description may not be more than 50 words in length and must
be provided to the Local Organizing Committee of the competition.
No audio description is allowed. If included, timing will begin and it will count toward the length
of the program. The team music will not be started until the team has taken their position and
given the hand signal signifying they are ready to start.
PROGRAM DESCRIPTION
Date:
Signature of Coach /
Team Manager:
Fun in the Sun
THEATRE ON ICE Competition
OFFICIAL TEAM ENTRY FORM for - Adult, Open, Novice, Junior & Senior
Part 3 of 4
Music Details:
Team Name:
Division:
Free Program
Overall Duration of Music (not skating time):
1st Cut
Title of Music:
Composer:
Name of Disc/Tape:
2nd Cut
Title of Music:
Composer:
Name of Disc/Tape:
3rd Cut
Title of Music:
Composer:
Name of Disc/Tape:
4th Cut
Title of Music:
Composer:
Name of Disc/Tape:
Duration Mins:Sec:
Orchestra or Instrumentalist:
Number of Disc/Tape
Duration Mins:Sec:
Orchestra or Instrumentalist:
Number of Disc/Tape
Duration Mins:Sec:
Orchestra or Instrumentalist:
Number of Disc/Tape
Duration Mins:Sec:
Orchestra or Instrumentalist:
Number of Disc/Tape
Choreographic Exercise
Overall Duration of Music (not skating time):
1st Cut
Title of Music:
Composer:
Name of Disc/Tape:
2nd Cut
Title of Music:
Composer:
Name of Disc/Tape:
3rd Cut
Title of Music:
Composer:
Name of Disc/Tape:
4th Cut
Title of Music:
Composer:
Name of Disc/Tape:
Duration Mins:Sec:
Orchestra or Instrumentalist:
Number of Disc/Tape
Duration Mins:Sec:
Orchestra or Instrumentalist:
Number of Disc/Tape
Duration Mins:Sec:
Orchestra or Instrumentalist:
Number of Disc/Tape
Duration Mins:Sec:
Orchestra or Instrumentalist:
Number of Disc/Tape
Fun in the Sun – Theatre on Ice Competition
OFFICIAL TEAM ENTRY FORM for - Adult, Open, Novice, Junior & Senior – Teams must consist of at least 8 but not more than 24 persons
List in Alphabetical order by Surname
First Name
Surname
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
Team Name:
DOB
Age on 1st July
Division:
State Membership #
Club Membership #
Passed ISA Preliminary Test
Name of Other Team–for Crossover Skaters