GalaxyCon Late Night "Heroes & Villains" Costume Contest Registration
Email address *
Full Name: (Please include names of all participants) *
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Email Address: (Please verify your email address is correct before submitting, or we will not be able to send your contestant number and information) *
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Which GalaxyCon city are you submitting for?
Phone Number: *
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Group or Individual: (If you are in a group, please submit one form per group) *
Character(s): (The name(s) of the character(s) that your costume is based on)
Your answer
What series or property does your character(s) come from? *
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Emergency Contact Name: *
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Emergency Contact Phone Number: *
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By checking this box you are verifying that you are 17 years of age or older *
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