Lions Club

Amateur Talent Contest

Entry Form

Entry Deadline:   March 9, 2012

 

 

Contestant Name___________________________________          Birth date: __/__/__

(for groups, attach a list of all participants, their birth dates, and ages as of July 1, 2011)

 

 

Address:________________________________________ Phone:_______________

 

 

Age as of July 1, 2011__________

 

Adult Contact___________________________Phone___________Email__________________

            (for groups, list ONE person to contact)

 

 

Division Entered:   A   B  C   D   E    F         (Please circle one)

 

A-Elementary- Ages 8 and under                   D-Junior- Ages 12 through 14

B-Intermediate- Ages 9 through 11                E-Senior-Ages 15 through 18

C-Groups- Ages 11 and under                       F-Groups-Ages 12 through 18

 

 

Type of performance___________________________________________________________

                        (Name type of performance, i.e., dance, solo, drama, vocal, instrumental, etc.)

 

 

Name of selection ___________________________________________________________

 

Special equipment needed ___________________________________________________

                                    (No special equipment will be furnished without prior arrangement)

 

 

Name of sponsoring Lions Club WEEPING WATER LIONS CLUB

 

 

Place:               Weeping Water School Auditorium

Date:                 Sunday, March 25, 2012

Time:                2:00 p.m. (School building opens at 1:00 p.m.)

Deadline:         Return entry form to Weeping Water Lions (address is below)

                         NO LATER THAN March 9, 2012

 

Please submit entry form to Weeping Water Lions, P.O. Box 202, Wepeing Water, NE 68463