Contestant Entry Form
Twelfth Annual Wiggles of the West
July 13-15, 2007



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



Deadlines for photos and bios - June 11, 2007
Deadline for entries - June 25, 2007

Dance name or Troupe name to be used in the contest:
My choice for line up position is first part, middle, last part.

$40.00 for the Entertainer of the Year category. Limited to 20 entries.

$35.00 for the Rising Star category. Limited to 15 entries.

$35.00 for the Headliner of the Year category. Limited to 15 entries.

$45.00 for the first three or four dancers and $5.00 for each additional dancer in our troupe for the Ensemble of the Year category. Realizing that the number of troupe members may change, the entry fee may be adjusted prior to June 25, 2007. Limited to 15 entries.
NUMBER OF TROUPE MEMBERS TOTAL for entry $

$35.00 for the Alternative Wiggles (soloist) category. Limited to 15 entries.

$45.00 for the first two dancers and $5.00 for each additional dancer in our troupe for the Alternative Ensemble category. Realizing that the number of troupe members may change, the entry fee may be adjusted prior to June 25, 2007. Limited to 15 entries.
NUMBER OF TROUPE MEMBERS TOTAL for entry $

Mini- Ensembles - limited to 15 entries.
$35.00 for Duet.
$45.00 for Trio.



$ TOTAL AMOUNT to be submitted


I will be paying with: Check or Money Order, PayPal.

Fees will be refunded only if the category is full.

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

Make all Checks or Money Orders payable to: Two Old Bags, PO Box 20366, Sun Valley, NV 89433. Note: $20 fee for returned checks.

We accept credit cards through PayPal.

Pay with PayPal

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.

I agree to abide by all the rules and regulations of the contest. I/we the entrant(s), agree that Two Old Bags, Boomtown Hotel & Casino or any of their associates regarding the Wiggles of the West contest, are not responsible to anyone or their heirs for personal injury, lost or stolen articles, etc., at or enroute to these events.

I authorize Two Old Bags to use or sell any or all photos/videos taken of me during the Wiggles of the West contest, for educational, promotional and professional purposes. I release all rights, compensation, and recourse to these events.

As WINNER, I will use the contest titles from Wiggles of the West, (Entertainer of the Year, etc.) correctly for publicity purposes and will reign with dignity.

By sending this form you agree to the above terms.



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"We reserve the right to refuse entry"