eTalent Entry Form

This is where the disclaimer goes ....

Participant Name *

First

Last

Address *

Address Line 1

City

State

Zip Code

Email *

Event *

Entry Category *

Parent's Name

Youtube Video Link *

Video Details *

Please provide : All Participants Name, Age, Video reference eg: Movie name (if it is referencing a movie) or anything that you would like to describe.

I agree that all of the above information that was provided is true to the best of my knowledge.

I authorize above mentioned YouTube video to be uploaded into facebook for the eTalent competition.

Electronically signed by (Name of the participant, or in case of minor, Parent or responsible adult) *

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eTalent Entry Form

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202-627-0576