NAME___________________________________________AGE. _______________

ADDRESS ____________________________________________________________
                  Street/City/State/Zip Code

PHONE: ________________________________________

CHECK ONE: ________PRE-TEEN (Age 12 & Under) _______ Teen (Age 13 to 18)_____Open (Any Age)

FEE: No charge

List Members of Group (Continue on back if more room is needed)

Name                                             Age      Address

_________________________ ______ ___________________________________

_________________________ ______ ___________________________________

_________________________ ______ ___________________________________

_________________________ ______ ___________________________________

DESCRIBE TALENT:

______________________________________________________________________

______________________________________________________________________

Check if needed: ___CD Player ___Tape Player

All acts are on a first-come first-serve basis with all acts to be performed on Sunday, July 29, 2012
at 2:00 pm on the stage in the City Square Park. Each act will be notified about the approximate time of
their performance.

I hereby acknowledge that I have read the information as stated and agree to abide by the
entry rules and that the personal data set forth is correct.

Signature of Contestant or Group Leader: ___________________________________

Return Entry Form by July 23, 2012

Chaska RCD Talent Contest
PO BOX 145
Chaska MN, 55318