CONTEMPORARY ENSEMBLE (11 DANCERS AND MORE) REGISTRATION Note** If not paying by PayPal or credit card, please read the instructions at the bottom of the page. Note* All dancers competing in the Ensemble competition must fill out this form for each INDIVIDUAL dancer in the Ensemble each must pay the fee at the bottom of the page. Form Date * MM DD YYYY Division * ENSEMBLE Name of Dancer * First Name Last Name Gender of Dancer * Male Female Date of Birth of Dancer * MM DD YYYY Age as of April 1, 2025 * Proof of ID with Photo * Please link toward a photo of a valid form of photo ID. No registration will be complete without it. http:// Phone Number of Dancer * Country (###) ### #### Email of Dancer * Country of Citizenship * Afghanistan Albania Algeria Andorra Angola Anguilla Antigua & Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia & Herzegovina Botswana Brazil Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China China - Hong Kong / Macau Colombia Comoros Congo Congo, Democratic Republic of (DRC) Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Fiji Finland France French Guiana Gabon Gambia, Republic of The Georgia Germany Ghana Great Britain Greece Grenada Guadeloupe Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran Iraq Ireland Israel and the Occupied Territories Italy Ivory Coast (Cote d'Ivoire) Jamaica Japan Jordan Kazakhstan Kenya Korea, Democratic Republic of (North Korea) Korea, Republic of (South Korea) Kosovo Kuwait Kyrgyz Republic (Kyrgyzstan) Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Madagascar Malawi Malaysia Maldives Mali Malta Martinique Mauritania Mauritius Mayotte Mexico Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar/Burma Namibia Nepal New Zealand Nicaragua Niger Nigeria North Macedonia, Republic of Norway Oman Pacific Islands Pakistan Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovak Republic (Slovakia) Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Sweden Switzerland Syria Tajikistan Tanzania Thailand Netherlands Timor Leste Togo Trinidad & Tobago Tunisia Turkey Turkmenistan Turks & Caicos Islands Uganda Ukraine United Arab Emirates United States of America (USA) Uruguay Uzbekistan Venezuela Vietnam Virgin Islands (UK) Virgin Islands (US) Yemen Zambia Zimbabwe Country Represented * Afghanistan Albania Algeria Andorra Angola Anguilla Antigua & Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia & Herzegovina Botswana Brazil Brunei Darussalam Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China China - Hong Kong / Macau Colombia Comoros Congo Congo, Democratic Republic of (DRC) Costa Rica Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Eswatini Ethiopia Fiji Finland France French Guiana Gabon Gambia, Republic of The Georgia Germany Ghana Great Britain Greece Grenada Guadeloupe Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hungary Iceland India Indonesia Iran Iraq Ireland Israel and the Occupied Territories Italy Ivory Coast (Cote d'Ivoire) Jamaica Japan Jordan Kazakhstan Kenya Korea, Democratic Republic of (North Korea) Korea, Republic of (South Korea) Kosovo Kuwait Kyrgyz Republic (Kyrgyzstan) Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Madagascar Malawi Malaysia Maldives Mali Malta Martinique Mauritania Mauritius Mayotte Mexico Moldova, Republic of Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar/Burma Namibia Nepal New Zealand Nicaragua Niger Nigeria North Macedonia, Republic of Norway Oman Pacific Islands Pakistan Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Reunion Romania Russian Federation Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa Sao Tome and Principe Saudi Arabia Senegal Serbia Seychelles Sierra Leone Singapore Slovak Republic (Slovakia) Slovenia Solomon Islands Somalia South Africa South Sudan Spain Sri Lanka Sudan Suriname Sweden Switzerland Syria Tajikistan Tanzania Thailand Netherlands Timor Leste Togo Trinidad & Tobago Tunisia Turkey Turkmenistan Turks & Caicos Islands Uganda Ukraine United Arab Emirates United States of America (USA) Uruguay Uzbekistan Venezuela Vietnam Virgin Islands (UK) Virgin Islands (US) Yemen Zambia Zimbabwe Name of Coach * First Name Last Name Phone Number of Coach * Country (###) ### #### Email of Coach * Contemporary Ensemble Title * Note* The length of the piece cannot exceed 5 minutes. Note** Choreography must be Choreographed between 2015 and 2024 Contemporary Ensemble Choreographer * Contemporary Ensemble Music * Note* The length of the music cannot exceed 5 minutes. Note** Please indicate name of Composer and name of the song in the field below. Names of Other Ensemble Dancers * Last Name, First Name, One Dancer per line with a ( , ) after every person's name. Signature of Parent or Legal Representative REQUIRED if dancer is under 18 years old. *Electronic Signature is considered a binding official signature.* Applicant Signature * For dancers 18 years old and over. *Electronic Signature is considered a binding official signature.* I have read and understood the VKIBC rules and regulations * Yes Payment Method * Note** This form will not be considered valid unless payment is made. If paying with PayPal or credit card, please scroll down and select Add To Cart. If paying with U.S. check, please make it to the order of VKDF and mail to: VKDF, 1725 York Avenue, Suite 10A, NYC, NY 10128. If paying via Wire Transfer, please see the info at the bottom of the page. PayPal or credit card U.S. Check Wire Transfer How did you hear about VKIBC ? * Facebook Instagram YouTube Twitter Email / Newsletter Search Engine Website Friend Coach Other Thank you! If Paying With Paypal or Credit Cardplease click “add to cart” and then proceed to Checkout Contemporary Ensemble (11 Dancers And More) Division $75.00 Quantity: Add to cart If Paying Via Bank WirePAYMENT DUE $75(THE DANCER MUST ADD US$15 BANK TRANSFER FEE TO THE PAYMENT). IF FEE IS NOT PAID WE WILL NOT REIMBURSE YOU & YOUR REGISTRATION WILL NOT BE ACCEPTED.CHASE BANK SWIFT CODE : CHASUS33ACCOUNT NUMBER : 755172320ROUTING NUMBER : 021000021BANK ADDRESS : 270 PARK AVE NYC, NY, USA 10017 If Paying by U.S. Check, Please Mail to:VALENTINA KOZLOVA DANCE FOUNDATION1725 YORK AVENUE, SUITE 10ANEW YORK, NY 10128