Talent Application

Name of Performer and/or Model *

First Name Last Name

Date of Birth *

- Month - Day Year

Sex *

Male Female

Measurements (B, W, H)

Models we will need your measurements in inches

Sizes (Dress, Pants, Shirt, Shoes)

Models please provide your most current sizes for dresses, pants, shirts, and shoes (please indicate if child or adult sizes)

Description of Talent *

If applying to model in one of our fashion shows, write Model, in the box above. If applying to be a performer in one of our talent shows please be specific - Type of Dance, Type of Vocal, Special talent Type the type of talent you will perform (e.g., Comedy, Marital Arts, Juggling, Baton Twirling, Magic - illusion, Instrumental - Saxophone, Vocal - Pop, Dance - Tap, etc.)

Title of Piece or Music (if applicable)

Props and Equipment *

all props and equipment must be approved by Talent for Epilepsy and the Venue at least one month before the show

Headshot *

Label the headshot as Performer's Full Name as it will Appear on our social media

Video of Talent/Modeling *

Please copy and paste a link to your videos on YouTube, Drive or DropBox

Short Bio *

50 word limit 0/50

Talent for Epilepsy will pay artist {zero dollars} as compensation for performances. Setup for the performance will be the responsibility of {Artist}. Talent for Epilepsy and it’s affiliates are not responsible for any injuries, damages, or claims made as a result of my involvement with Talent for Epilepsy, including but not limited to auditions, rehearsals, or the event itself. This agreement releases Talent for Epilepsy and it’s affiliates from all liability relating to injuries that may occur during Talent for Epilepsy events, including but not limited to performances, fittings, auditions, etc. By signing this agreement, I agree to hold Talent for Epilepsy and it’s affiliates entirely free from any liability, including financial responsibility for injuries incurred, regardless of whether injuries are caused by negligence. I also acknowledge the risks involved. I swear that I am participating voluntarily, and that all risks have been made clear to me. Additionally, I do not have any conditions that will increase my likelihood of experiencing injuries while engaging in this activity. By signing below I forfeit all right to bring a suit against Talent for Epilepsy and affilates for any reason. In return, I will receive participation in activity. I will also make every effort to obey safety precautions as listed in writing and as explained to me verbally. I will ask for clarification when needed. Photo/Video Release: AUTHORIZATION TO USE PHOTOGRAPHS AND/OR AUDIO-VISUAL. I hereby authorize event photographer/videographer, Talent for Epilepsy (Organization), and affiliates to use, reproduce, and/or publish photo-graphs and/or video that may pertain to me— including my image, likeness and/or voice without compensation. I understand that this material may be used in various publications, public affairs releases, recruitment materials, broadcast public service advertising (PSAs) or for other re-lated endeavors. This material may also appear on the Organization’s or project sponsor's Internet Web Page. This authorization is continuous and may only be withdrawn by my specific rescission of this authoriza-tion. Consequently, the Organization or project sponsor may publish ma-terials, use my name, photograph, and/or make reference to me in any manner that the Organization or project sponsor deems appropriate in or-der to promote/publicize service opportunities. Artist’s Performance Commitment: If for any reason you need to cancel please remember that this is a charity event and cancellation effects the charity and everyone involved. If the need to cancel should occur please extend the courtesy of canceling at least one week prior to the event. Thank you for volunteering your time and Talent to Talent for Epilepsy.

Performer or Legal Guardian: I fully understand and agree to the above terms *

Full Name of Legal Guardian (If performer is over 18 type in name of Performer again

Date *

- Month - Day Year

Phone Number of Talent or Guardian (if under 18) *

- Area Code Phone Number

Email Address of Talent or Guardian (if under 18) *