Karl Richter Community Center TALENT SHOW REGISTRATION FORM

Holly’s Got Talent!

on Saturday,April 22, 2016

Karl Richter Auditorium @ 7:00PM

Return to KRCC 300 East St Holly, MI 48442 no later than April 15th.

1st Prize $100

2nd Prize $50

3rd Prize $25

  1. This registration is for (check one):
  2. Individual Entry ______b. Group Entry ______

Only one member of the group should complete the form, but each partner must have a parent sign permission slip if under 18

Name (if Group Act, you must list all names here)

Name EmailParent EmailHome Phone

2.

3.

4.

(Please print VERY clearly! Do not use an e-mail address that you do not check often.)If more than four people in a group act, add the name and information at the back of the page.

  1. Type of Talent (check one category):

Dance____ Skit ______Song _____ Other ____

Other (Please specify below.)

______

______

  1. Title of Performance (or Group Name)______
  1. Brief description of Act (Song, Dance, Magic Act, Vocal, Juggling, etc):

______

______

  1. Will performance include props? Yes _____ No _____
  • If yes, to #5 please explain in space below (i.e., 2 tables, 1 chair, upright piano, music stand ……)
  • Special setup or arrangement required? Yes _____ No _____
  • (If you have any special needs or requests not listed on this form, please be sure to note that here in detail.):

______

Rules:

Please supply own music on CD due5 days prior to performance.

The length of the act should not be more than 10 minutes including your set up time.

The order of appearance will be randomly selected by draw from a hat.

Up to 3 microphones will be provided for each group.

All participants agree to: The undersigned, on behalf of himself or herself, or as a parent or guardian of such individual, assumes all responsibility for the above participant while enrolled in the activities sponsored by KRCC, with respect to any actions taken in pursuance of such activities, either before or after the activity. Moreover, it is agreed that the Village of Holly and its departments and employees shall not be liable for any property damage, and/or personal injury, and/or other loss or damage suffered by the participant, and the participant, on his or her own behalf, or as parent or guardian of participant, release and forever discharge each of the entities and persons from any and all actions, causes of actions, claims and demands with respect to any and all such damages, injury or loss. In the event of any injury, permission is hereby given to KRCC, and to the Director, or his or her agent, or employee, to see that first aid and medical attention are given to the participant, at the discretion of the Parks & Recreation or KRCC personnel. Video recording may be done and/or pictures may be taken at certain Parks and Recreation parks, facilities, classes, programs and/or special events, KRCC and, unless the department receives signed, written objections, videos and photos may be reproduced for publication.

Voting will be by audience participation(ballot), Audience reaction (peak dB reading), and possibly by internet voting.

10 participants will go on to a second round where winner will be determined by audience participation (ballots).

Participation fee of $10 for individual entry or $5 per participant for group entry must be paid at time of sign up.

SIGNATURE(s) required for each group member. This acknowledges that all parties understand and consent to the above stated rules and their participation in the Talent Show.

______

(signature)(parent signature if under 18)

______

(signature)(parent signature if under 18)

______

(signature)(parent signature if under 18)

______

(signature)(parent signature if under 18)

Please re-check the form to ensure that you have answered all questions.

Please Note: YOU MUST CONTACT THE COMMITTEE if you do not receive any

correspondence verifying receipt of your registration form by April 19th,2016.

Thank you.

Committee Members :

Name Phone Email

Terry

Toni