Enter Now - Talent Wairarapa

Contact Information

Name*

First Last

Address*

Street Address City State / Province / Region ZIP / Postal Code

Email

Phone*

Category*

Please note if one of your performers is over 14 then you will need to go into the over 14 category

How many performers are in your act?*

Performer Details

First Name	Last Name	Date of Birth

Please list all of the performers in your act - use the plus at the end of the field to add more performers

Describe your Act / Performance*

Please give as much detail as possible

Preferred Heat Time*

Times will be allocated into your preferred time slot on a first come first served basis

You must abide by the terms and conditions of this competition as laid out by Carterton Rotary Club - they can be found here

Please confirm*

Entry Fee - $5 per act*

Price: $ 5.00

All profits from Talent Wairarapa go to youth related projects.

Total

$ 0.00

Credit Card

American Express

Discover

MasterCard

Visa

Card Number Expiration Date Security Code Cardholder Name

Comments

This field is for validation purposes and should be left unchanged.