Entry Form Updated PDF
Entry Form Updated PDF
Sekretariat :
Jln. Kalisari Dharma 10/17, Pakuwon City, Surabaya, HP : +6289502567799
e-mail : kejurdajatim@gmail com
PRIA / WANITA/
WANITA PRIA
Nama :
Tgl Lahir :
Telp./Fax :
e-mail :
Club Asal :
Kota/Kab. :
TTD & Stempel PengKab/PengKot :
SOLO EVENTS Beri tanda () DANSA UMUM Beri tanda ()
STANDARD Grade E1 W Hip Hop U16
Grade E2 QS Hip Hop U21
Grade D1 W, QS BBOY U16
LATIN Grade E1 S BBOY Adult
Grade E2 C BGIRL
Grade E3 R Traditional DS U16
Grade E4 PD Traditional DS U21
Grade E5 J Traditional DS Adult
Grade D1 S, R
Grade D2 C, J
Grade C1 C, R, J
Grade C2 S, R, PD
Grade B S, C, R, J
LDS C DUO EVENTS Beri tanda ()
LDS J Synchronized C, J
Pendaftaran ulang :
Tempat : Register desk - Main Atrium, Lenmarc Mall, Lantai UG, Surabaya
Tgl / waktu : 28 November 2021/ mulai pk. 08.45 - 09.30 WIB