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Entertainment Submission

2. Performer or Band Name*

4. First Name*

5. Last Name*

7. Title*

   What is your relationship with the performer/band, i.e. booking agent, member of the band, etc?

9. Phone Number*

10. Email*

12. Address*

14. City*

15. State*

16. Zip Code*

18. Website

19. Facebook Address

21. YouTube or other Video Address

23. Type of Entertainment*

    1. Children's
    2. Dance
    3. Magic
    4. Music
    5. Strolling
    6. Other

25. If other, please explain.

27. Please provide two professional references:

29. Please add any additional information:

Leave This Blank:


31. 1. Receive an email copy of this form.
32. Email address

    This field is not part of the form submission.

33. Submit

* indicates a required field