Medium Group (4-10 participants) Registration $100
Hosted at Sharon Lynne Wilson Center for the Arts in Brookfield, Wisconsin – Saturday September 21, 2017.

Please complete payment on paypal here: http://bit.ly/2seg8RJ

ABOUT PARTICIPANT 1
1. Name
Your answer
Date of Birth
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Grade Enterting in Fall
Hometown
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Any Health Concerns to be Noted
Your answer
ABOUT PARTICIPANT 2
2. Name
Your answer
Date of Birth
MM
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DD
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YYYY
Grade Enterting in Fall
Hometown
Your answer
Any Health Concerns to be Noted
Your answer
ABOUT PARTICIPANT 3
3. Name
Your answer
Date of Birth
MM
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DD
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YYYY
Grade Enterting in Fall
Hometown
Your answer
Any Health Concerns to be Noted
Your answer
ABOUT PARTICIPANT 4
4. Name
Your answer
Date of Birth
MM
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DD
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YYYY
Grade Enterting in Fall
Hometown
Your answer
Any Health Concerns to be Noted
Your answer
ABOUT PARTICIPANT 5
5. Name
Your answer
Date of Birth
MM
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DD
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YYYY
Grade Enterting in Fall
Hometown
Your answer
Any Health Concerns to be Noted
Your answer
ABOUT PARTICIPANT 6
6. Name
Your answer
Date of Birth
MM
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DD
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YYYY
Grade Enterting in Fall
Hometown
Your answer
Any Health Concerns to be Noted
Your answer
ABOUT PARTICIPANT 7
7. Name
Your answer
Date of Birth
MM
/
DD
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YYYY
Grade Enterting in Fall
Hometown
Your answer
Any Health Concerns to be Noted
Your answer
ABOUT PARTICIPANT 8
8. Name
Your answer
Date of Birth
MM
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DD
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YYYY
Grade Enterting in Fall
Hometown
Your answer
Any Health Concerns to be Noted
Your answer
ABOUT PARTICIPANT 9
9. Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Grade Enterting in Fall
Hometown
Your answer
Any Health Concerns to be Noted
Your answer
ABOUT PARTICIPANT 10
10. Name
Your answer
Date of Birth
MM
/
DD
/
YYYY
Grade Enterting in Fall
Hometown
Your answer
Any Health Concerns to be Noted
Your answer
ABOUT YOUR PERFORMANCE
Type of Talent you will be competing in (i.e. dance, singing, musical performance, etc.)
Your answer
Name for your Performance Piece
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Estimated Time of Performance (all performances must be 3 minutes or less)
Your answer
PARENT CONTACT
Guardian Name
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Relationship
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Emergency Contact for Day of Event
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Phone Number
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DETAILS
Best Email Address to Pass Along Details for Event
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