Street Dance USA Registration

Please fill out all the relevant information on this page then click submit at the bottom of the page to send your entry.
ALL participants must provide the information below to be able to participate in the US Championships.

This section is to be completed by the principle person in charge of the group or freestyler.

Title:
First Name:
Last Name:
D.O.B
Address:
Street:
City:
State:
Zip
Tel no:
Mobile
Email:

If we are unable to reach you, please give details of a secondary person that we may contact.

Full Name:
Contact No
Email:

Group / Freestyle Information

Select entry type	Group Freestyler
Name of Group or Freestyler
Parent company / organization name	(if applicable)
Which Town is your Group / Freestyler based in?
Age Category
No of Members	(Max 16)
Gender of Group / Freestyler	Male Female Mixed
How long has the Group been together?
If any, which other competition have you participated in?
Do you think that you could win the Championships, and represent the US. If so why?