Name *

If Group Act you must list all members first and last names here.(5 Max)

Stage Name *

i.e. your stage name or the name of your group/band.

Type of Act *

Check One Please

Dance

Skit

Comedian

Singer

Musician

Art

Magic

Other

Brief Description of Act *

(Lip Sync, Dance, Magic Act, Vocal, Juggling, etc)

Email Address *

Guardians Name *

Guardians Name

First Name

Last Name

Thank you!