CHRISTIAN COUNTY FAIR TALENT COMPETITION
ENTRY FORM
Name of Act _________________________________________________________________
Contact Person or Legal Guardian ____________________________________________
(Must be no younger than twenty-one (21) years of age)
Address _____________________________________________________________________
_____________________________________________________________________________
Telephone ___________________________________________________________________
Should you receive a monetary prize, to whom should the check be payable?
Name _______________________Social Security Number.__________________________
Please list below ALL members that will be competing along with ALL pertinent information.
NAME BIRTHDAY COUNTY
RESIDENCE MO/Day/YR
In the space provided below, please briefly describe your act/talent, and indicate what kind of accompaniment you will be using.
Feel free to make as many copies as needed
Submit to Kathy Hooper, Talent Director, Christian County Fair, 18 Laurel Lane, Taylorville, IL 62568
Entries must be postmarked no later than midnight, April 30, 2009.
It is acknowledged by the parties hereto that the Participant and all persons performing pursuant to this, contract t hereby agree to indemnify and hold harmless the Christian County Fair Board, its agents arid officers from any liability for injuries to the person, whether for bodily injury, sickness, mental anguish or death of the Participant or persons performing pursuant to this contract and as to claims for any damage to any of their property. The Participant and all persons performing pursuant to this contract hereby agree to indemnify and hold harmless the Christian County Fair Board, its agents and officers from any liability to third parties arising out of the performance of this contract. By signing this contract, it is agreed that all Participants will adhere to all rules and accept the finality of the judges’ decision without challenge.
Signature __________________________________________________________________
(Contact person or legal guardian no younger than twenty-one (21) years of age)
ENTRY BLANK- Please use separate blank for each department.
For late entries, contact superintendent.