Lip Sync Kombat Registration Form
This registration is for the Lip Sync Kombat at ACX 2017.

This contest happens on July 30, 2017 (Sunday).

To join the contest, please fill up registration form below and complete the required details.

Email address
Personal Information for Contestant 1
First Name
Your answer
Last / Family Name
Your answer
Stage Name
An alias you would like us to use when you are called onstage
Your answer
Age
Your answer
Character Cosplaying and Series
Please state the Character you are cosplaying and the Series from which the character originated
Your answer
Personal Information for Contestant 2
First Name
Your answer
Last / Family Name
Your answer
Stage Name
An alias you would like us to use when you are called onstage
Your answer
Age
Your answer
Character Cosplaying and Series
Please state the Character you are cosplaying and the Series from which the character originated
Your answer
Contact Information
Working Mobile / Cellphone number
Please provide your active mobile numbers (one number per line) We may use this to contact you regarding the contest
Your answer
Active email address
Please provide an active email address. We may use this to contact you regarding the contest
Your answer
Song List
Song List
Please provide up to four (4) titles of your song choices, one song per line. When possible, please provide artist/singer and album/series where it comes from for easy identification.
Your answer
Confirmation and Form Submission
By submitting this form, I -

Confirm that the information I have provided is true, complete and accurate;

Agree to the contest rules and regulations as stated; and

Will follow and abide by the contest rules and regulations.

A copy of your responses will be emailed to the address you provided.
Please complete the captcha before submitting the form.
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