Vineland Rotary Club Cumberland County's Got Talent

Thank you for applying to be a contestant in the Vineland Rotary Fundraiser “Cumberland County’s Got Talent” on April 26, 2008.

Name: ___________________________________________ Date of Birth: _______________

Address: ______________________________________________________________________

___________________________________________________________________

Home Phone: ______________________ Cell Phone: ___________________

Email Address: ______________________

Parent/Legal Guardian (if under 18 years old): _______________________________________________

Stage or Group Name (if applicable): _______________________________________________

Talent Category (check all that apply to your act):

Number of People in Your Act: _____

Please Briefly Describe Your Act: ______________________________________________________________________
______________________________________________________________________
______________________________________________________________________

Please list the title and composer/artist of each song you intend to perform (if applicable): ___________________________________________________________________________________________________________________________

I understand that the Vineland Rotary Club reserves the right to refuse an audition to any individual or act, in its sole discretion, should you at any stage supply untruthful, inaccurate, or misleading personal details or information.

I have read, understand, and agree with the above.

Signature: _______________________________________________
Date: _______________ (if the contestant is under the age of 18 years, the parent or legal guardian of such person should sign above)

There is a non-refundable application fee of $10.00. The fee must be paid with submission of the application. Please make checks payable to:

Vineland Rotary Charities Foundation

Please complete and sign the application form and mail to:

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