2024 IDPWD, Music Talent Showcase: Competition Entry Form

2024 IDPWD, Music Talent Showcase: Competition Entry Form

Let us know how we can help you! info@ebenmission.org.au
1. Personal Information
Full Name

First NameLast Name
Date of Birth
Participants's Phone Number
Please enter a valid phone number.
Guardian's Phone Number
Please enter a valid phone number.
Participant's Email
example@example.com
Guardian's Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Disability (if applicable):(This is optional and can be used to ensure appropriate accommodations are provided)
2. Performance Information
Type of Performance
Performance Title (Song title/piece):
Length of Performance (in minutes):
Any Special Requirements (e.g., sound equipment, seating, accessibility needs):
3. Terms & Conditions
I acknowledge that by submitting this form, I am registering to participate in the music competition held on December 7th.
I agree to comply with all event guidelines and understand that the organizers will provide further instructions closer to the event date.
4. Emergency Contact Information
Name of Emergency Contact
Relationship to Participant
Phone Number
Please enter a valid phone number.
5. Consent and Signature
I consent to my performance being recorded or photographed for promotional purposes (Yes/No).
Signature (or Guardian's signature if under 18):
Date:
Should be Empty:

1. Personal Information