Youth Showcase Application - Howard County MD Chapter The Society, Incorporated

Performer

Complete one application per performer.

Performer's full name

First

Last

Age

School

Grade

Performer's email

Performer's cell phone

know Relationship full

Performer's address

Address Line 1

Address Line 2

City

State

Zip Code

Talent category

Title of piece

Parent/guardian

Required for all performers. Performers 18 and older may enter their own information.

Parent/guardian name

First

Last

Relationship to performer

Parent/guardian phone

Parent/guardian email

A copy of this application will be emailed to this address.

Emergency contact name and phone (if different)

Allergies or medical needs we should know about (optional)

Permission

I give permission for the performer named above to audition for the Youth Showcase & Talent Show and, if selected, to perform at the showcase. I understand a parent or guardian must stay on site during the audition. All performances must be family-friendly; music must be a clean version with no profanity or inappropriate content.

Photo and video release

Photo and video release (choose one)

I give permission for The Society, Incorporated, Howard County (MD) Chapter to photograph and record the performer for judging, chapter communications, social media, and promotion of chapter programs, without payment.
I do not give permission for photos or recordings of the performer, except recordings used only by judges for scoring.

Signature

Performers 18 and older may sign for themselves.

Signature (type your full name)

Typing your name here serves as your signature.

Agreement

I am the parent/guardian of the performer named above (or the performer, age 18 or older). I agree to the permission statement and the photo and video release choice above.