KIDS HAVE TALENT
2019 TALENT SHOW ENTRY FORM
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) ________________________
NAME OF SELECTION_____________________________________________________________________
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_________________
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 _______________