Individual or Group Name
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If Group, Name of Contact Person
Contact Email Address
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Address
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City
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State
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Zip
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Home Phone
Work Phone
Mobile Phone
Describe Talent
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If Musician, Name of Song and name of artist
Number of Persons In Your Act
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Have you, your group or anyone in your group ever performed the above talent as a professional? (Meaning the principle source of your income is performing)
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Yes
No
By Initializing the box below -- I acknowledge that I have read the entry rules and agree to abide by them.
Parent Name (if under 18)
Initials of Contestant or Parent/Legal Guardian if under 18
*