PRE-REGISTRATION FORM

SATURDAY, AUGUST 2, 2014 at 12:00 NOON

WV BLACKBERRY FESTIVAL TALENT SHOW

FORM & $10.00 CHECK MUST BE REC’D NO LATER THAN AUGUST 1, 2014

Mail to: WV Blackberry Festival Talent Contest 2014

C/o Linda Griffith

PO Box 8088

Nutter Fort, WV 26302

NOTE: NO ENTRIES ACCEPTED DAY OF CONTEST

NAME: _______________________________________________________________________

ADDRESS:

PHONE:______________________________ Cell:

E-MAIL:

AGE ON DAY OF TALENT SHOW:

CATEGORY IN WHICH YOU WILL PERFORM:

BAND	❑ (3 members or more)

COMEDY	❑

DANCE	❑

INSTRUMENTAL	❑

SINGING	❑

ACCOMPANIED BY:	CD	❑ Or Tape ❑

NAME OF YOUR MUSICAL SELECTION:

ORIGINALLY SUNG/PERFORMED BY:

OR

SOMETHING YOU COMPOSED Yes ❑ No ❑

If you would like the Master of Ceremonies to say a little bit about you, what would you like him/her to say? (For instance, have you won any awards for your talent in the past? Have you performed any place really special to you?) _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

ALL ACTS MUST BE NO LONGER THAN 4 ½ MINUTES

The West Virginia Blackberry Festival is not responsible for any incident or injury to any individual that may occur as a result of performing on stage. By signing this form, the performer agrees not to hold The Blackberry Festival liable for any incidents were it to occur.

____________________________________________

NAME	DATE____________________________________________ (Guardian or parent must sign if entrant is under 18 years of age.)