Open Mic Night Registration & Waiver Form
Brenham Community Education, in conjunction with Brenham Independent School District, is excited to invite you to our Fall Open Mic Night! Please be advised that this is a family event and all acts should be appropriate for all ages. Acts will be limited to 3 - 5 minutes. Microphone and speaker will be provided; however, you will need to bring any additional materials or items needed for your performance. Please make sure you read and complete all portions of this form in its entirety.

All performer registrations should be submitted by 4pm, Friday 11/09/2018.

For additional information and/or questions please visit brenhamcommunityed.com or call 979-277-3895 ext. 2171.

Email address *
First & Last Name: *
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Gender: *
Birthdate: *
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Age: *
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Name of School: *
(if you are a Brenham ISD student or staff member)
Grade:
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Phone Number (including area code): *
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Address (include street, city, state & zip): *
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Please select the option that applies to you: *
Emergency Contact #1 (Please include Full Name, Phone Number & Relationship): *
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Emergency Contact #2 (Please include Full Name, Phone Number & Relationship): *
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