Tri-State’s Got Talent Registration & Release Form

Name of Act *

Contact Name *

First

Last

Phone *

Address

Street Adress, City, State, Zip

Email Address *

Are All Members of Your Act 18 Years or Older? *

This information is used to determine who is eligible to sign their own use of video/photography releases.

Number of Performers in the Act *

Description of Your Act *

As used herein, "Producer" shall include The Arc of Evansville, Inc., its licensees, successors, and assigns, and each of their respective officers, directors, shareholders, employees, agents, and representatives. I agree that Producers may license, assign, and otherwise transfer this Talent Registration and Release Form and all rights granted by me under this Talent Registration and Release Form to any person or entity. I understand that Producer reserves the right to refuse an audition to any individual or act, in its sole discretion, for any reason or no reason.

Your response will serve as legal agreement or refusal to the above listed information. Additional release forms may be required.

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