Amstelveen 2024 Para Dance Sport

International Competition

29-31 March 2024

ENTRY FORM

Couple	Partner / Man		Partner / Lady
Surname / Name
Date of birth dd/mm/year
EVENTS
Combi Standard
Combi Latin
Duo Standard
Duo Latin
Single Conventional Woman / Man
Power Wheelchair
Combi Freestyle
Duo Freestyle
Single Freestyle Woman / Man
Juniors
Class 1-2 (please indicate)
Wheelchair user (please indicate)
SDMS number:
STAFF Coaches, supporters
NPC:
Contact person:
Tel/Fax		E-mail:

Amateur Declaration Statement:

An athlete is eligible to compete in World Para Dance Sport only if he or she is not a National coach in WPDS, team leader, coach or

representative of a national team, adjudicator, standing dancer from the Professional Division in Dance Sport.

“According to the clause 3.3 of the 2018 IPC WPDS Rules and Regulations, I declare I am eligible to compete

in Wheelchair Dance Sport”.

Athletes’ signature:

Date:

Signature and stamp                              (                                    )

National Paralympic Committee or relevant organization, endorsed by NPC.

The Entry Form should be sent by e-mail no later than 20th of February 2024

info@dutchparadance.nl and info@WorldParaDanceSport.org