Preliminary Entry Form Please return this form before 8 th January, 2017 : National Synchronized Skating Committee (Comité national de patinage synchronisé) : stephane.durieux@hpe.com; christine.picavet2@free.fr; cabon.raphael@orange.fr; Organizing Committee (Comité d organisation) : skatehainautvalenciennesclub@gmail.com; valerie.durut@gmail.com; capridomi58@yahoo.fr Club Adress City Web Site Name of (Person to contact) Email Name of the Coach Email Date Signature
Team Entry Form 1 Please return this form before 12 th February, 2017 : National Synchronized Skating Committee (Comité national de patinage synchronisé) : stephane.durieux@hpe.com; christine.picavet2@free.fr; cabon.raphael@orange.fr; Organizing Committee (Comité d organisation) : skatehainautvalenciennesclub@gmail.com; valerie.durut@gmail.com; capridomi58@yahoo.fr ISU Member Club Adress City Web Site Number of Skaters Name of (Person to contact) Email Name of the Coach Email Entry Fee 290,00
Team Entry Form 2 Please return this form before 12th February, 2017 :National Synchronized Skating Committee (Comité national de patinage synchronisé) :stephane.durieux@hpe.com; christine.picavet2@free.fr; cabon.raphael@orange.fr;organizing Committee (Comité d organisation) : skatehainautvalenciennesclub@gmail.com; valerie.durut@gmail.com; capridomi58@yahoo.fr ISU Member Coach Chaperon 1 Chaperon 2 Competitors list in alphabetical order, indicate the team captain with an C and J for Jocker Name Surname Date of Birth Citizenship or Licence Number for French Team
Competition Music Information Form 3 Please return this form before 12th February, 2017 :National Synchronized Skating Committee (Comité national de patinage synchronisé) :stephane.durieux@hpe.com; christine.picavet2@free.fr; cabon.raphael@orange.fr;organizing Committee (Comité d organisation) : skatehainautvalenciennesclub@gmail.com; valerie.durut@gmail.com; capridomi58@yahoo.fr ISU Member Short Program 1 2 3 4 5 6 7 Music Composer Time (mn) Free Program 1 2 3 4 5 6 7 Music Composer Time (mn) Date Signature
Program Content Sheet Form 4 Please return this form before 12th February, 2017 :National Synchronized Skating Committee (Comité national de patinage synchronisé) :stephane.durieux@hpe.com; christine.picavet2@free.fr; cabon.raphael@orange.fr;organizing Committee (Comité d organisation) : skatehainautvalenciennesclub@gmail.com; valerie.durut@gmail.com; capridomi58@yahoo.fr ELEMENTS IN ORDER OF SKATING DURING THE PROGRAM Time * Elements Short Program Time * Elements Free Program * Time of element during the program
Extra Practice Form 5 Please return this form before 12th February, 2017 :National Synchronized Skating Committee (Comité national de patinage synchronisé) :stephane.durieux@hpe.com; christine.picavet2@free.fr; cabon.raphael@orange.fr;organizing Committee (Comité d organisation) : skatehainautvalenciennesclub@gmail.com; valerie.durut@gmail.com; capridomi58@yahoo.fr ISU Member Person to Contact Price per Block (15 mn) Amount of Blocks Total 40,00 - Method of payment : Chek (in Euros) / Cash (in Euros) / Bank Transfer
Team Travel Information Form 6 Please return this form before 12th February, 2017 :National Synchronized Skating Committee (Comité national de patinage synchronisé) :stephane.durieux@hpe.com; christine.picavet2@free.fr; cabon.raphael@orange.fr;organizing Committee (Comité d organisation) : skatehainautvalenciennesclub@gmail.com; valerie.durut@gmail.com; capridomi58@yahoo.fr ISU Member Number of People Arrival Date Departure Date Type of Transport Hotel Address
Meal Reservation / Form 7 Please return this form before 26th February, 2017 : Organizing Committee (Comité d organisation) : skatehainautvalenciennesclub@gmail.com; valerie.durut@gmail.com; capridomi58@yahoo.fr Days Lunch Diner Total Friday March,17, 2017 Warm Meal Number Warm Meal Number 11,00 - Warm Meal Number Lunch Box Number 11,00 8,00 - Saturday March 18, 2017 Lunch Box Number 8,00 - Sunday March 19, 2017 Warm Meal Number Lunch Box Number 11,00 8,00 - Total - Method of payment : Chek (in Euros) / Cash (in Euros) / Bank Transfer
Ticket Reservation Form 8 Please return this form before 26th February, 2017 :Organizing Committee (Comité d organisation) : skatehainautvalenciennesclub@gmail.com; valerie.durut@gmail.com; capridomi58@yahoo.fr Days Price Number Pass One Day Adult (Saturday or Sunday) 9,00 - Pass One Day Children (Saturday or Sunday) 4,50 - Pass Two Day Adult (Saturday and Sunday) 15,00 - Pass Two Day Children (Saturday and Sunday) 7,00 - Total - Free for Children under 3 years old Children under 12 years old Method of payment : Chek (in Euros) / Cash (in Euros) / Bank Transfer
Summary Form 9 Please return this form before 26th February, 2017 :Organizing Committee (Comité d organisation) : skatehainautvalenciennesclub@gmail.com; valerie.durut@gmail.com; capridomi58@yahoo.fr Method of payment : Chek (in Euros) / Cash (in Euros) / Bank Transfer Inscription 290,00 Total Extra Practice Form 5 - Total Team Meal Reservation Form 7 - Total Ticket Reservation Form 8 - Total 290,00 Date Signature