Fich Tama. ANG 2015 .pdf

Nom original: Fich Tama. ANG 2015.pdf
Auteur: manouche

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‘ORI TAHITI NUI SOLO COMPETITION - 2015
MERIDIEN TAHITI, Samedi 28 novembre 2015
Fiche d’Inscription JEUNE ou TAMA
contact : tumata.robinson@mail.pf or manouche@mail.pf
Please verify the category in which you are to compete on Saturday morning November 28th. Registration
will be between 7h00 am to 8h30 am, the competition will star tat 9h00 pm.
Division Young or Tama, Garçons or Tamaroa & Girls or Tamahine :
‘Aiu
6 à 8 ans
Tamaiti
9 à 11 ans
Taure’a
12 à 15 ans

Surname :

Birth date:

___________________________________________

___________________________________________

Name :

Name of group or dance school:

____________________________________________ ___________________________________________
E mail :

Telephone :

___________________________________________

___________________________________________

Engagement:
Waiver (All participants required to sign below):
I hereby agree to respect and abide to all the rules instituted by ‘ORI TAHITI NUI’ for the 4th 'ORI TAHITI NUI
COMPETITION – 2015 scheduled on the Island of Tahiti Saturday November 29th. I agree not to hold ‘ORI TAHITI
NUI’ responsible for any loss or damage caused to my personal property, or for any bodily harm or injury
occurred during this event. I will be responsible for any/all expenses caused by injuries to staff or degradation
arising as a result of my negligence or willful misconduct of services and facilities of the Hotel hosting the event.
Finally I give exclusive rights to ' ORI TAHITI NUI to use any photos or videos taken during the event for
promotional use.
In witness of my agreement to the terms above, I affix my signatures

Signature of parent/legal tutor:______________________________________________Date :__________________
Signature of dancer:_______________________________________________________________________________

Droit d’entrée :
2500 F CFP

Payé en espèces le
Payé par chèque bancaire B

Catégorie :
____________________________

____________________________

‘ORI TAHITI NUI présente

‘ORI TAHITI NUI SOLO COMPETITION 2015 -

Fiche d’Inscription JEUNE ou TAMA