KIDS HAVE TALENT
2019 TALENT SHOW ENTRY FORM

CONTESTANT INFORMATION:

NAME: ________________________________________________ AGE:_____________________________

ADDRESS:_____________________________________CITY: ________________________STATE: ______

PHONE:______________________________________DATE OF BIRTH:_____________________________

CATEGORY INFORMATION: (Circle One) CHILDREN’S (Age 5-11) Youth (Age 12-18)
TYPE OF ACT: Vocal (Type)_________________________ Instrumental(Type)________________________

Dance (Type) ________________________
Miscellaneous (Type)_______________________

NAME OF SELECTION_____________________________________________________________________

AUTHOR________________________________________________________________________________

GROUP NAME (Limit 5 to Group)_____________________________________________________________

MEMBERS IN GROUP BIRTHDATE ADDRESS PHONE NO.

Information on each member MUST be included above. All members MUST meet the age qualifications of 5-18 as of September 21, 2019. Each participant MUST have a signed Release Form from parent or guardian. CONTESTANTS MAY COMPETE ONLY ONCE each year.

Please list below the contact name & complete mailing address where all correspondence should be mailed:
Parent or Guardian _________________________________________________ Phone_________________
Address___________________________________City_______________________ State_______________

Entry Fees: $10.00. A non-refundable check or money order payable to C.F.F.I. Entry Form must be signed by Parent or Guardian. Applications MUST to be received by 5:00 pm Tuesday, September 17, 2019 at ISTC, 125 S. Penn. Ave., Independence, KS 67301. (Hours 1:00-5:00 Mon.-Sat.) Medals will be awarded to first, second, third place winners, as well as People’s Choice.

NOTE: MODERN WOODMEN FRATERNAL FINANCIAL will provide a matching grant of up to $1,500.00 for Kids Have Talent Contest Fundraiser.

I (we) have read the rules governing the Talent Contest and agree to abide by them.
I (we) release to the Talent Show any photos, film or publication.
Signature(s) of all Contestants in act __________________________________________________________

I have read the rules governing the Talent Contest and give my child permission to participate.
Signature of Parent or Guardian __________________________________________ Date _______________