4x4 Dance Championship Registration Form
Impact Dance is looking for passionate young dancers to join the 4x4 Dance Championship 2019.

We especially welcome the following genres: Hip-Hop/Street Dance/Street Jazz/ Jazz/Bollywood/Bhangra/Contemporary and any fusion of the above.

You can enter into one of the following categories:
11-15 years & 16-19 years.
Brent Based (containing at least 1 member living, working or studying in Brent)
OR
Non-Brent Based (no members from Brent)

The dance pieces need to be a minimum of 2 minutes and a maximum of 3 minutes.

Companies will perform at the heats at the brand new community space The Yellow, 1 Humphry Repton Lane, Wembley, HA9 0GL. The final is due to take place outdoors at ARENA SQUARE in Wembley outside the iconic SSE Arena.

To register for the 4x4 Dance Championship, please complete and submit the following application. There is a £10 registration fee per group (£2.50 per person, per group)!

Deadline for all registrations is:
Wednesday 13th March

Name of Group *
Your answer
Group Leader Name *
Your answer
Group Leader Contact No. *
Your answer
Group Leader Email *
Your answer
Are you a Brent Based or Non-Brent Based group? (Brent based = 1 member living, working or studying in Brent); (Non-Brent based = no members from Brent) *
What age category is your group? *
Style/Genre *
Your answer
Additional Team Members Information
Team Member Full Name, London Borough & Age *
Your answer
Team Member Full Name, London Borough & Age *
Your answer
Team Member Full Name, London Borough & Age *
Your answer
Team Member Full Name, London Borough & Age
Your answer
Registration Fee
Once you have submitted your registration form, please send the registration fee of £10.00 via either of the following methods:

Cheque: made payable to IMPACT DANCE FOUNDATION LTD
to IMPACT DANCE, The Courtyard, 100 Villiers Road, London, NW2 5PJ

BACS Transfer: ACCOUNT NO. 34318555 SORT 09-01-29

Upon selection for one of the HEATS you will be asked to supply information about ALL 4 dancers in your group. This information includes: Full Name, School, Home Address, Emergency Contact Information, Email Address, as well as, disclosure of any Medical Conditions
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