THE MAINE STATE FEIS

Please mail individual entry form for each dancer and check to :

Carlene Stillson 67 Alexander Drive, Gorham, Maine 04038

The Maine State FEIS Saturday July 24, 2010.

PRINT NAME: _____________________________________________________________

ADDRESS: ________________________________________________________________

CITY: ________________________STATE:__________________ ZIP: ________________

PHONE: ______________________DATE OF BIRTH___________ AGE AS OF 1/1/2010____

COMPETITION(S) BY NUMBER: ______________________________________________

PRELIMINARY: Reel__ or Slipjig__ /   Jig__ or Hornpipe__    OPEN: Reel__ Slipjig__

TEACHER'S NAME________________________SCHOOL  NAME_________________________AMOUNT ENCLOSED $_______

THE STILLSON SCHOOL, CARLENE STILLSON, BIDDEFORD BOARD OF EDUCATION, AND FEIS COMMITTEE ARE NOT RESPONSIBLE FOR INJURY AND/OR DAMAGE WHICH MAY OCCUR DUE TO NEGLIGENCE.

CLOSING DATE FOR ENTRIES IS JULY 6th,2010.  ENTRIES RECEIVED AFTER THIS DATE WILL BE SUBJECT TO A $10.00 LATE ENTRY FEE PER FAMILY.   NO ENTRIES WILL BE ACCEPTED AFTER JULY 17, 2010.  CHANGES MADE AFTER JULY 6 AND BEFORE JULY 17 WILL BE ACCEPTED WITH A $10 CHANGE FEE.  NO CHANGES WILL BE ACCEPTED AFTER JULY 17, 2010.  NO ENTRIES WILL BE ACCEPTED THE DAY OF THE FEIS, BY TELEPHONE OR EMAIL.

PARENT'S SIGNATURE:__________________________________________DATE: ____________

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