2016 canadian baton twirling championships master entry form

2016 CANADIAN BATON TWIRLING CHAMPIONSHIPS
MASTER ENTRY FORM
ALL ATHLETES (INDIVIDUAL AND GROUPS) MUST EACH COMPLETE THIS PAGE
PLEASE COMPLETE THIS PAGE AND ATTACH TO THE ENTRY FORM PAGE WITH ONE
CHEQUE/MONEY ORDER PER PROVINCE TO COVER ALL FEES.
ALL OTHER PAGES (Party Reservations, Good Luck Grams, Pride of Canada Clinic, etc.)
SHOULD ALSO BE ATTACHED TO EACH ATHLETE’S ENTRY FORM AND THESE FEES
INCLUDED ON THE CHEQUE/MONEY ORDER ALONG WITH ENTRY FEES.
Name Of Athlete:
CBTF Membership #
Address
Club
City
Province
Phone: (
)
Postal Code
Birthdate: Year ______ Month ____ Day ____
Coach’s Name
CBTF Membership #
Level ___
Coach’s Name
CBTF Membership #
Level ___
Choreographer’s Name
CBTF Membership #
Contact Person’s Email
All athletes/groups must declare any medical support/brace worn for the prevention of injury as deemed necessary by a
physician. Copy of medical certificate must accompany this entry.
SUMMARY OF FEES ENCLOSED:
INDIVIDUAL/
DUET/PAIR
ENTRY FORM
GRAND TOTAL
$
GYM FEE
($40 for Athletes in
Open Events Only, $50
for Athletes in Winner/
Championship Events)
$
ATHLETE’S
PARTY
($25 each)
$
ADDITIONAL
GOOD LUCK
GRAMS
($5 each)
$
PRIDE OF
CANADA
CLINIC
($40/athlete)
$
ADVERTISING
$
GRAND TOTAL
$
CHEQUE OR MONEY ORDER TO BE MADE PAYABLE TO "ABTA"
with a note on the
Memo/Reference line indicating 2016 Canadian Championships/Gym Rental, etc.
ALL ATHLETES COMPETING IN ANY EVENT AT CANADIANS ARE REQUIRED TO SUBMIT THE FOLLOWING SIGNED CBTF WAIVER FORM
CBTF WAIVER – PARTICIPANT’S ASSUMPTION OF RISK
I am aware and understand that there are a number of inherent risks involved in my participation in this sporting activity that are beyond
the control of the Canadian Baton Twirling Federation, Alberta Baton Twirling Association, Competition Officials and Grant MacEwan
University. I further agree that I am assuming personal responsibility for any costs as well as any loss, damage, injury or ambulance
service resulting from or in connection with such participation at the Canadian Baton Twirling Federation National Championships, July 2 –
July 8, 2016. I have read and understand the Waiver.
Signature (parent/guardian, if athlete under 18 years)
Print ________________________________ Sign __________________________________ Date ___________________
2016 CANADIAN BATON CHAMPIONSHIPS
INDIVIDUAL / DUET / PAIR ENTRY FORM
CBTF SANCTION # CBTF-16-pending (Winner/Championships)
CBTF SANCTION # CBTF-16- pending (Maple Leaf Open)
Name Of Athlete:
CBTF Membership #
Birthdate: Year ______ Month ____ Day ____
Coach’s Name:
CBTF Membership #
EVENT
MAPLE LEAF OPEN
CANADIAN WINNER / CHAMPIONSHIP
(circle status level)
(circle status level)
Medley
OPEN
C
OPEN
BN
OPEN
BI
OPEN
A
WINNER
BN
WINNER
BI
CHAMPIONSHIP
A
Solo Dance
Twirl
OPEN
C
OPEN
BN
OPEN
BI
OPEN
A
WINNER
BN
WINNER
BI
CHAMPIONSHIP
A
Solo
OPEN
C
OPEN
BN
OPEN
BI
OPEN
A
WINNER
BN
WINNER
BI
CHAMPIONSHIP
A
Men’s Solo
OPEN
C
OPEN
BN
OPEN
BI
OPEN
A
WINNER
BN
WINNER
BI
CHAMPIONSHIP
A
2-Baton
OPEN
C
OPEN
BN
OPEN
BI
OPEN
A
WINNER
BN
WINNER
BI
CHAMPIONSHIP
A
3-Baton
OPEN
C
OPEN
BN
OPEN
BI
OPEN
A
WINNER
BN
WINNER
BI
CHAMPIONSHIP
A
Duet
OPEN
C
OPEN
BN
OPEN
BI
OPEN
A
WINNER
BN
WINNER
BI
CHAMPIONSHIP
A
--
--
--
--
LEVEL B
LEVEL A
--
--
--
--
LEVEL B
LEVEL A
Freestyle
(includes Compulsories or Short
Program)
Pair
Duet Partner’s Name & CBTF #________________________________________ (Both members must complete and submit an entry)
Pair Partner’s Name & CBTF #________________________________________ (Both members must complete and submit an entry)
Number of
Events
ENTRY FEE SUMMARY
Fee per Event
Total
INDIVIDUAL EVENTS (MAPLE LEAF OPEN)
x $ 15.00
$
DUET EVENT (MAPLE LEAF OPEN)
x $ 7.50/pp
$
CANADIAN INDIVIDUAL WINNER/CHAMPIONSHIP EVENTS
x $ 45.00
$
CANADIAN DUET WINNER/CHAMPIONSHIP EVENT
x $ 22.50
$
FREESTYLE EVENT
x $110.00
$
PAIR EVENT
x $55.00/pp
$
GRAND TOTAL FOR INDIVIDUAL/DUET/PAIR ENTRY FORM
$
GYM FEE FOR MAPLE LEAF OPEN EVENT ATHLETES IS $40.
GYM FEE FOR CANADIAN WINNER/CHAMPIONSHIP ATHLETES IS $50. PAY ONLY HIGHEST FEE.
2016 CANADIAN BATON CHAMPIONSHIPS
WINNER/CHAMPIONSHIP GROUP ENTRY FORM
CBTF SANCTION # CBTF-16-pending (Winner/Championships)
This form to be used for ALL GROUPS entering from each club
PLEASE PRINT CLEARLY
Name Of Club___________________________________________________________________________________
Director/Coach's Name(s): __________________________________
Phone (_____)_______________________
Director/Coach’s Email___________________________________________________________________________
PLEASE INCLUDE COPY OF EACH GROUP’S OFFICIAL CBTF 2016 GROUP ROSTER
NAME OF GROUP
(as it is to appear in the
program)
EG
“Monster Mash”
AGE
DIVISION
(JUVENILE,
JUNIOR,
SENIOR)
Juvenile
SIZE
(B, A)
(SMALL,
LARGE)
EVENT
NUMBER
OF
MEMBERS*
B
Small
Dance Twirl Team
6 + 1 ALT
LEVEL
ENTRY FEES
$14 PP
CDN W/C
$15.00 pp
1
$15.00
2
$15.00
3
$15.00
4
$15.00
5
$15.00
6
$15.00
7
$15.00
TOTAL
$105.00
GRAND TOTAL FOR WINNER/CHAMPIONSHIP GROUP ENTRY FORM
NOTES TO COACHES/CLUB DIRECTORS:
•
Winner/Championship Events: Dance Twirl Team, CBTF/WBTF Team, WBTF Group
•
Level C groups (all events), and Pom Pom Teams or Theme Production (all age divisions & skill level), are eligible to compete in
the Maple Leaf Open Competition only
•
The Primary Age Division is not offered in the Canadian Winner/Championship event. Primary groups may compete in the
Juvenile Division in the Winner/Championship. A Primary division IS offered in the Maple Leaf Open Competition.
•
All teams/groups competing in the Canadian Winner/Championship event must have qualified at their Provincial Championships
in the same division (Age , Level and Size)
•
If you wish Alternate(s) to receive an award, they must be listed on the Group Roster and have their entry fee paid
•
Please leave Age Division, Level and Size blank when entering WBTF Group
GYM FEE – EACH GROUP ATHLETE MUST SUBMIT THE MASTER ENTRY FORM (IF NOT ALREADY SUBMITTING AS AN
INDIVIDUAL ATHLETE) AND INCLUDE THE APPROPRIATE GYM FEE.
2016 CANADIAN BATON CHAMPIONSHIPS
MAPLE LEAF OPEN GROUP ENTRY FORM
CBTF SANCTION # CBTF-16- pending (Maple Leaf Open)
This form to be used for ALL GROUPS entering from each club
PLEASE PRINT CLEARLY
Name Of Club___________________________________________________________________________________
Director/Coach's Name(s): __________________________________
Phone (_____)_______________________
Director/Coach’s Email___________________________________________________________________________
PLEASE INCLUDE COPY OF EACH GROUP’S OFFICIAL CBTF 2016 GROUP ROSTER
NAME OF GROUP
(as it is to appear in the
program)
EG
“Lollipop”
AGE
DIVISION
(PRIMARY,
JUVENILE,
JUNIOR,
SENIOR)
Primary
LEVEL
SIZE
(C, B, A)
(SMALL,
LARGE)
EVENT
C
Small
Dance Twirl Team
NUMBER
OF
MEMBERS*
5 + 1 ALT
ENTRY FEES
$7 PP
TOTAL
OPEN
$7.00
1
$7.00
2
$7.00
3
$7.00
4
$7.00
5
$7.00
6
$7.00
7
$7.00
$42.00
GRAND TOTAL FOR OPEN GROUP ENTRY FORM
NOTES TO COACHES/CLUB DIRECTORS:
•
Maple Leaf Open Events: Dance Twirl Team, Pom Pom Team, Twirl Team, CBTF/WBTF Team, WBTF Group
•
Level C groups (all events), and Pom Pom Teams or Theme Production (all age divisions & skill level), are eligible to compete in
the Maple Leaf Open Competition only
•
The Primary Age Division IS offered in the Maple Leaf Open Competition
•
If you wish Alternate(s) to receive an award, they must be listed on the Group Roster and have their entry fee paid
•
Please leave Age Division, Level and Size blank when entering WBTF Group
GYM FEE – EACH GROUP ATHLETE MUST SUBMIT THE MASTER ENTRY FORM (IF NOT ALREADY SUBMITTING AS AN
INDIVIDUAL ATHLETE) AND INCLUDE THE APPROPRIATE GYM FEE.
Deadline Date: Received by May 24, 2016
FREE TO COMPETING ATHLETES
(MAXIMUM 10 WORDS)
PLEASE PRINT CLEARLY
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________
ADDITIONAL GOOD LUCK GRAMS (10 WORDS OR LESS) ARE $5.00
PLEASE PRINT CLEARLY
GOOD LUCK GRAMS @ $5.00 EACH (10 words or less):
AMOUNT ENCLOSED
_____________________ PAYABLE TO (payable to "ABTA", note Good-LuckGram in the Memo field)
THE FRIENDSHIP EXCHANGE
Back by popular demand this year are the Athlete Welcome Bags!
We will divide the athletes into age categories. Each athlete is asked to bring a small gift for
each twirler in their age category to put in the welcome bags.
When the athletes arrive at the Athlete’s Party on July 3, they will have a
fantastic bag filled with an assortment of things from their twirling friends
from around the country.
The gifts should be inexpensive and NUT FREE - you
can even hand-make them. We will try to keep the
categories to manageable numbers.
Please personalize your gifts with your best wishes,
name and club or province.
Once the Canadians entry forms are processed, you will receive an email from myself
([email protected]) letting you know how many athletes are in your category, as well as the age
range.
Sincerely,
Chantal Sutton,
CBTF Athletes’ Rep
******************************************************************************
Please include this form with your Canadians Entry Package.
(please print clearly)
Twirler’s Name:
Email Address:
Age of Twirler on Dec 31, 2015:
Province:
__
Club:____________
Athlete Name: ______________________________________________________
Email: ______________________________________________________
Age: ______________ Prov: _______________
Club: _________________________________________________
Food Allergies: _______________________________________________________________________________________________________
NUMBER OF TICKETS: _______________ @ $25.00/ticket: __________________
(Include this form & amount with the Master Entry Form page)