Dancer Name:

Birth Date:

Email:

Phone #:

Mailing Address:

City:

Province/State:

Country:

Postal Code:

Age (as of August 26th 2017):

ScotDance # (2017):

Category:

Teacher:

 

Entry Fees

Cost: Primary $15.00, Beginner – Premier $25.00, Late $10.00

Primary:

Beginner – Premier:

 

Tickets

All dancers will be mailed a gate pass as it is included in their entry fee. Advanced tickets for family members may also be purchased below.

Adult – $15.00:

 

Total:

|**Please take note of the total above. This is the amount that you will need to enter on the PayPal payment page**

I hereby for myself, my heirs, executors and administrators, waive and release any and all rights and claims I may have for damages against the North Lanark Highland Games (NLHG) and against the Town of Mississippi Mills, their respective directors, agents and representatives, for any injuries that may be suffered by me or my child in competition or while on the premises during the event. I hereby give permission for the names and/or photos of the dancer listed above to be used by the NLHG on their website and other publications