Performer or Group Name _______________________________________Date______________
Total # of Performer(s)/Adult_______ Minor(s) total #________
Contact Person: _____________________________________
Performer(s) Name(s): 1.______________________Minor Y / N
2._______________________________________Minor Y / N
3._______________________________________Minor Y / N
4._______________________________________Minor Y / N
5._______________________________________Minor Y / N
6._______________________________________Minor Y / N
Write more names on the next printed page if needed.
4. FINAL STEP: CHECK & INITIAL THAT YOU HAVE COMPLETED & READ THE SHOW REQUIREMENTS:
[ ] Filled Out Performer(S) Information Form / Initial______
[ ] Read General Information & Rules / Initial______
[ ] Read KIMO Theater General Information / Initial______
[ ] Sent YouTube Link or [ ] Mailed DVD / Initial_______
[ ] Atttached/Submitted Lyrics / Initial_______
[ ] Mailed $25 Application Fee (non-refundable) / Initial_______
[ ] Printed / filled out information & email to:[email protected] or returned via USPS mail to:
Sinatra DeVine Productions, Inc.; 4119 Dietz Loop, NW;
Los Ranchos de Albuquerque, NM 87107
Contact Person Address:__________________________________
City: _______________ State:_____ Zip Code: ________
Contact Phone Number: ___________________________________
Contact E-mail: _________________________
Song/Performance Title_____________________________________________________ (Attach the lyrics to your music contract for interpreters)
Length________
YouTube Link:________________________
Props Description:_______________________________________________
__________________________________________________________
Preference to perform will be taken into consideration .
Thursday [ ] Friday [ ]
There will be an opportunity of puchasing a video(s) of the contest. Are you interested in purchasing a copy? Yes [ ] No [ ]
Please read / sign in the box below and to the right if more signatures required: "I have completed the information and understand the rules in all documents. As a performer in the Sinatra Devine Productions, Inc. "Got Talent, New Mexico?" production held September 28-30, 2017, I do hereby hold harmeless and waive all rights to any type of lawsuit against Sinatra Devine Production, Inc., Board Members, liaisons, volunteers, and those contracted by Sinatra DeVine Productions, Inc. I hereby release the herein-mentioned parties all rights to any videotape, photographic and sound recordings made of the show and relinquish all rights to them. I have also read and understand the: General Information & Rules CLICK HERE and the KIMO Theater General Information CLICK HERE in this packet."
*Adult Performer or Parent/Legal Guardian Signature:_______________________
Print Minor's Name if Applicable_______________________
*Additional performers, parent/guardian-minor names to the right. More names needed write on next page with signatures of performer and/or parent/legal guardian (minor's name(s) included).
More Signatures if Needed
*Adult Performer or Parent/Legal Guardian Signature:_______________________ Print Minor's Name if Applicable_______________________
*Adult Performer or Parent/Legal Guardian Signature:_______________________ Print Minor's Name if Applicable_______________________
Sinatra DeVine Board Contact: (for office use)
Initil:__________ Contract Signed___________Payment Rcv’d________
You Tube Link Uploaded______ / DVD Rcv’d ______
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