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DANCE COMPETITION REGISTRATION FORM MEMBER ASSOCIATION DANCE CATEGORY Couple Dancer One Address City State or Phone Zip or Province Postal Code Email It is OK to release this information to other IGRA members for dance-related purposes. Yes No NAMES TO USE IN PRESS RELEASES AND PROGRAM FOR THIS CONTEST 1st Name Only Full Name Division I Advanced Division III Beginner Division II Intermediate Division IV First Time FREESTYLE SONG TITLE ARTIST I CERTIFY THAT THE ABOVE NAMED CONTESTANTS S ARE MEMBERS IN GOOD STANDING AND ELIGIBLE TO REPRESENT OUR ASSOCIATION AT THE IGRA COUNTRY WESTERN DANCE COMPETITION IN THE STATED CATEGORY. Association President or Trustee printed name Signature Exhibit D2 Page 1 of 3 Date 1/1/2013 Individual Line Dancer Open Dance Team Individual Dancer Dance Team Contact Name REGISTRATION FEES 75. 00 per couple if postmarked 30 days prior to opening of IGRA University 100. 00 per couple 15-30 days prior 35. 00 per individual line dancer 30 days prior to opening of IGRA University 100. 00 per team if postmarked 30 days prior to opening of IGRA University 125. 00 per team 15-30 prior POST MARK DATE MAIL ENTRY FORM APPROPRIATE FEES NON-REFUNDABLE PAYABLE TO IGRA 20140 East Maplewood Ln Centennial CO. Yes No NAMES TO USE IN PRESS RELEASES AND PROGRAM FOR THIS CONTEST 1st Name Only Full Name Division I Advanced Division III Beginner Division II Intermediate Division IV First Time FREESTYLE SONG TITLE ARTIST I CERTIFY THAT THE ABOVE NAMED CONTESTANTS S ARE MEMBERS IN GOOD STANDING AND ELIGIBLE TO REPRESENT OUR ASSOCIATION AT THE IGRA COUNTRY WESTERN DANCE COMPETITION IN THE STATED CATEGORY. Association President or Trustee printed name Signature Exhibit D2 Page 1 of 3 Date 1/1/2013 Individual Line Dancer Open Dance Team Individual Dancer Dance Team Contact Name REGISTRATION FEES 75. Association President or Trustee printed name Signature Exhibit D2 Page 1 of 3 Date 1/1/2013 Individual Line Dancer Open Dance Team Individual Dancer Dance Team Contact Name REGISTRATION FEES 75. 00 per couple if postmarked 30 days prior to opening of IGRA University 100. 00 per couple 15-30 days prior 35. 00 per couple if postmarked 30 days prior to opening of IGRA University 100. 00 per couple 15-30 days prior 35. 00 per individual line dancer 30 days prior to opening of IGRA University 100. 00 per team if postmarked 30 days prior to opening of IGRA University 125. 00 per individual line dancer 30 days prior to opening of IGRA University 100. 00 per team if postmarked 30 days prior to opening of IGRA University 125. 00 per team 15-30 prior POST MARK DATE MAIL ENTRY FORM APPROPRIATE FEES NON-REFUNDABLE PAYABLE TO IGRA 20140 East Maplewood Ln Centennial CO. Yes No NAMES TO USE IN PRESS RELEASES AND PROGRAM FOR THIS CONTEST 1st Name Only Full Name Division I Advanced Division III Beginner Division II Intermediate Division IV First Time FREESTYLE SONG TITLE ARTIST I CERTIFY THAT THE ABOVE NAMED CONTESTANTS S ARE MEMBERS IN GOOD STANDING AND ELIGIBLE TO REPRESENT OUR ASSOCIATION AT THE IGRA COUNTRY WESTERN DANCE COMPETITION IN THE STATED CATEGORY. Association President or Trustee printed name Signature Exhibit D2 Page 1 of 3 Date 1/1/2013 Individual Line Dancer Open Dance Team Individual Dancer Dance Team Contact Name REGISTRATION FEES 75. 00 per couple if postmarked 30 days prior to opening of IGRA University 100. 00 per couple 15-30 days prior 35.

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