Jareeda Magazine - Belly Dancer USA

Belly Dancer USA™
Competition & Middle Eastern Bazaar

June 9-10, 2012

Name
Dance Name
Address
City , State , Zip Code
Phone
Email address

Years of Experience
Teachers

Deadline for entries - May 31, 2012

Dance name or Troupe name to be used in the contest:

Competition Categories

Apprentice category, $30.00.

Hobbyist category, $30.00.

Golden Girls Category, $30

Goddess category, $30.00.

Dance of the 7 Veils category, $30.00.

Alternative Music category, $30.00.

Alternative Music Professional category, $35.00.

2012 Bellydance Duet USA category $40.00

2012 Bellydance Troupe USA category, $30.00 for the first dancer and $10.00 for each additional dancer.
Number of troupe members

2012 Belly Dancer USA category, $50.00.

$ TOTAL AMOUNT to be submitted check/money order PayPal.

Check or PayPal payment MUST be received within 10 days of sending this form.

Make all Checks or Money Orders payable to: Mezdulene, PO Box 680, Sutherlin, OR 97479

We accept payment through PayPal (Use jareeda@jareeda.com).

Return to this page and click the "I Agree" button at the bottom of this form, check the information in the body of the email to make sure all the information is correct then send. If you wish you can change the subject line to read "Contest Entry".

I authorize Jareeda, Mezdulene, Mystical Oasis, The Belly Dancer U.S.A. Competition™ entities, Associates and/or heirs to use or sell any or all photos or videotapes taken during said competition, for educational, promotional and professional purposes. Any competitor winning any category of The Belly Dancer U.S.A. Competition™ agrees to use the title of that category correctly for publicity purposes. Competitors assume all responsibility and liability for themselves and all personal property. All applications, forms, contracts, releases, moneys, etc. must be signed by competitor (using the "I agree" button denotes an electronic signature) and received by The Belly Dancer U.S.A. Competition™ or its staff, before being accepted into any category in the Competition. If I m crowned winner of The Belly Dancer U.S.A. Competition™, I agree to return the following year to peform in the evening show and present that year's winner his/her crown. I agee to abide by all "Rules of The Belly Dancer U.S.A. Competition™." I agree to the above and I do hereby release Jareeda, Mezdulene, Mystical Oasis, The Belly Dancer U.S.A. Competition™ and anyone working with or connected to The Belly Dancer U.S.A. Competition™ from any claims for any kind of damages, loss, theft or injuries incurred while participating in this competition.

Date

By sending this form you agree to the above terms.

Events Sponsored by Jareeda
--Belly Dancer USA Contest and International Bazaar
--Mezdulene's Annual Belly Dance Retreat

SUBSCRIPTIONS: U.S.A. $30; Canada $36 a year; other countries $46. Make checks payable to: JAREEDA and send to P.O. Box 680, Sutherlin, OR 97479. Visa and MasterCard also accepted; for information: e-mail jareeda@jareeda.com