Mokena's Got Talent Entry Form 2019
Contestants Last Name *
Your answer
Contestants Date of Birth *
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Legal Guardians Last Name *
Your answer
Legal Guardians First Name *
Your answer
Contestants Phone Number *
Your answer
Guardian Phone Number *
Your answer
Contestants Email *
Your answer
Guardian Email *
Your answer
Mailing Address *
Your answer
Stage or Group Name if different from contestant name *
Your answer
Description of Act *
Your answer
Names of additional performers in act if any (type none if solo act) *
Your answer
Names of additional performers in act if any (type none if solo act) Each additional performer must submit a registration form and release *
Your answer
GENERAL RELEASE Please read and check the box below in lieu of a signature. We hereby grant permission for our child (listed above as "contestant") to participate in Mokena’s Got Talent. I/We hereby release All About Music, Inc., (here in referred to as The Company) from any and all liability, damages, or claims whatsoever for any injury or harm that may occur to my Child while participating in any rehearsal, activity or performance provided by The Company.  I agree that I will make no claim or demand against the Company if an injury or accident occurs during any rehearsal, activity or performance provided by the Company.  I will look to my own resources, insurance or assets to pay all medical bills, damages or losses whatsoever if any injury occurs.  The term Company includes all employees, subcontractors, volunteers and staff of the Company participating in Mokena’s Got Talent.  In addition the Company may use any photographs or video taken of my Child while participating in Mokena’s Got Talent for publicity or promotion.  *
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