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FInsc. Anglais Duo 2015 .pdf


Nom original: FInsc. Anglais Duo 2015.pdf
Auteur: manouche

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‘ORI TAHITI NUI DUO COMPETITION - 2015
MERIDIEN TAHITI, Sunday November 29th 2015
Registration sheet DUO
Contact : tumata.robinson@mail.pf or manouche@mail.pf
To participate in the Duo contest, les 2 artists must be a minimum of 16 years old.
the Duo contest will be held on Sunday November 29th at the Meridien hotel. Registration will be from
1h00 PM to 2h00 PM and the competition will star tat 2h30 pm.
Vahine ‘Ori
Tane ‘Ori
Date of Birth____________________________

Date of Birth_______________________________

Name ______________________________________

Name ______________________________________

Surname ___________________________________

Surname ___________________________________

E mail:

Name of group or dance school:

___________________________________________
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
th
COMPETITION – 2015 scheduled on the Island of Tahiti Saturday November 29 . 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 Vahine ‘Ori :

Signature Tane ‘Ori :

Or Signature of parent/legal tutor:______________________________________________Date :__________________
Affiliation:_______________________________________________________________________________

Droit d’entrée :
4.000 F CFP

‘ORI TAHITI NUI présente

Payé en espèces le
Payé par chèque bancaire B

Pehe :
______________________________

_________________________________

_______________________________

‘ORI TAHITI NUI DUO COMPETITION 2015 -

Fiche d’Inscription DUO


Aperçu du document FInsc. Anglais Duo 2015.pdf - page 1/1

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