Entry Form Kids Have Talent – Independence Science & Technology Center

Fill out the application in person, or copy this entry form and past into an email. Fill it out and email it to indyscitech1@gmail.com. Entry fees may be paid through our donation button located on our website or in person. All entries must be submitted by Wednesday, September 20th to participate.

KIDS HAVE TALENT
2023 TALENT SHOW ENTRY FORM

CONTESTANT INFORMATION:

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) _____________________________

Miscellaneous (Type)______________________

NAME OF SELECTION____________________________________

AUTHOR______________________________________

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 30th, 2023. 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________________________
Address_____________________________________________________________

City_______________________ State_______________

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 30, 2023 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.

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.

I understand that ISTC is not legally liable for injuries.
Signature of Parent or Guardian __________________________________________

Date _______________