Please mail individual entry form for each dancer and check to :
Carlene Stillson 67 Alexander Drive, Gorham, Maine 04038
The Maine State FEIS Saturday July 23, 2011.
PRINT NAME: _____________________________________________________________
ADDRESS: ________________________________________________________________
CITY: ________________________STATE:__________________ ZIP: ________________
PHONE: ______________________DATE OF BIRTH___________ AGE AS OF 1/1/2011____
COMPETITION(S) BY NUMBER: ______________________________________________
PRELIMINARY: Reel__ or Slipjig__ / Jig__ or Hornpipe__ OPEN: Reel__ Slipjig__
TEACHER'S NAME________________________SCHOOL NAME_________________________AMOUNT ENCLOSED $_______
THE STILLSON SCHOOL, CARLENE STILLSON, BIDDEFORD BOARD OF EDUCATION, AND FEIS COMMITTEE ARE NOT RESPONSIBLE FOR INJURY AND/OR DAMAGE WHICH MAY OCCUR DUE TO NEGLIGENCE.
CLOSING DATE FOR ENTRIES IS JULY 5th,2011. ENTRIES RECEIVED AFTER THIS DATE WILL BE SUBJECT TO A $10.00 LATE ENTRY FEE PER FAMILY. NO ENTRIES WILL BE ACCEPTED AFTER JULY 16, 2011. CHANGES MADE AFTER JULY 5 AND BEFORE JULY 16 WILL BE ACCEPTED WITH A $10 CHANGE FEE. NO CHANGES WILL BE ACCEPTED AFTER JULY 16, 2010. NO ENTRIES WILL BE ACCEPTED THE DAY OF THE FEIS, BY TELEPHONE OR EMAIL.
PARENT'S SIGNATURE:__________________________________________DATE: ____________