Morristown's Got Talent! Registration

ALL FIELDS ARE REQUIRED.
1.	Individual / Group Name:


2.	Contact Information:
	Name:
	Company:
	Address:
	Address 2:
	City/Town:
	Zip/Postal Code:
	Country:
	Phone Number:
	Email Address:

3.	List all other people in act:
	Name:
	Address:
	Phone Number:
	Email Address:

4.	List all other people in act:
	Name:
	Address:
	Phone Number:
	Email Address:

5.	List all other people in act:
	Name:
	Address:
	Phone Number:
	Email Address:

6.	List all other people in act:
	Name:
	Address:
	Phone Number:
	Email Address:
7.	Category of Talent:


8.	Name of Song:


9.	Please indicate your preferred time slot for audition:


10.	Rules and Regulations Agreement:
	I acknowledge that I have read the rules and regulations and agree to abide by them.

11.	Photograph and Information Release Form::
	I hereby give my permission to allow my name and photograph to be placed in the program for Morristown's Got Talent. I further agree to allow Morristown's Got Talent to photograph and/or videotape me at the show and that such photographs or videotape may be broadcast or published by public media including, but not limited to, local newspapers and television.

12.	Please sign (type name) and date to confirm your registration for Morristown's Got Talent:
	Signature of Contestant:
	Date (format: mm/dd/year):


		*Required