Friends of Children with Special Needs

STEP ONE
ENTER INFO
STEP TWO
CONFIRMATION
STEP THREE
RECEIPT

DEADLINE TO SUBMIT ENTRY FORM is Monday, January 13, 2025.

Entry fees should be paid by credit cards. Please have your credit card information ready before completing this entry form. After we receive your audition form(s) and entry fee(s), a confirmation email and a payment receipt will be emailed to you. Your audition number, as well as further instructions will be provided in separate email prior to the audition date. Please contact sn.talentshow@fcsn1996.org or 510-739-6900 ext.3319 if you have any questions or would like to request for other payment options.

IMPORTANT: Please submit entry form for each solo or group act.

For Group Act Entries: Please have all your group member's information before completing this form. If your group exceeds 8 members, please DO NOT complete this form and contact sn.talentshow@fcsn1996.org or 510-739-6900 x3319 for special registration.

Audition Registration

$10

Audition Entry Fee (Per Solo/Group Act)

Select Individual or Group Act: *

Group Information (if applicable)

Group Name:

Contestant Information

Contestant Name: *

(First Name & Last Name)

Date of Birth: *

Age: *

Sex: *

Address: *

City: *

State: *

Zip Code: *

Country: *

Phone Number: *

Email: *

Diagnosis: *

IEP School District
(if applicable):

Regional Center
(if applicable):

2nd Contact Information

The 2nd contact person other than the contestant(s)

Contact Person: *

(First Name & Last Name)

Phone Number: *

Email: *

Type of Performance

• A maximum of 2 minutes per act are allotted for the preliminary auditions.
• A maximum of 5 minutes per act will be allotted for the final competition.
• Your performance will be stopped at the end of the allotted time.

Please check the type of performance you will be performing: *

If Other or Combination, please describe:

Type of Instrument
(if applicable):

Style of Dance
(if applicable):

Song Name & Artist/Composer: *

Audition Date Arrangement

Do(es) the contestant(s) live within a 50-mile radius of
Fremont, CA (FCSN Osgood Center at 42080 Osgood Road, Fremont, CA 94539)?

Performer Release Agreement

Program’s Name: FCSN’s Special Needs Talent Showcase

Producer: Friends of Children with Special Needs (FCSN), FCSN volunteer photographers, and FCSN’s contradicted videographer and crew.

I, the undersigned, do hereby release all my rights to the sound and picture recording made of me by Friends of Children with Special Needs, its photographers, and its videographer, producer, and film crew. I hereby authorize the reproduction, sale, copyright, exhibition, and/or distribution of said recording by the said producer, or agents thereof, without limitation.

It is understood and agreed that said producer’s use of my appearance and/or the material supplied by me will not violate the rights of any person or organization(s) and will not incur any liability for payment to any person or organization(s). I do further release and hold harmless the producer and FCSN, its staff, against any liability and expenses (including attorney fees and expenses incurred by any of the above mentioned parties) with respect to any claim that my words, actions or any material supplied by me violate the right of any person or organization. I hereby release, discharge and agree to hold harmless FCSN, its photographers and videographers, his representatives, assigns, employees, or any person or persons, corporation or corporations acting under his permission or authority, or any person, persons, corporation or corporations, for whom he might be acting, including any firm publishing and/or distributing the finished product, in whole or in part, from an against any liability as a result of any distortion, blurring, or alteration, optical illusion, or use in any composite form, either intentionally or otherwise, that may occur or be produced in the taking, processing or reproduction of the finished product, its publication, distribution, or broadcast of the same, even should the same subject video inadvertently lead to personal ridicule, scandal, reproach, scorn or indignity.

In addition it is understood and agreed that FCSN, its photographers, and its producer of record, may, but need not, use said recorded programming, or photographs as is determined at the soul discretion of the representative(s) of FCSN, its photographers, and/or the producer of record.

Acknowledgement: *

I acknowledge that I had read Agreement and agreed to the Terms and Conditions listed in the above Performer Release.

For more information about registration, contact sn.talentshow@fcsn1996.org or 510-739-6900 ext. 3319.

Payer Information

First Name: *

Last Name: *

Billing Address: *

This is the address where your credit card statements are mailed.

Address 2:

City: *

State / Province: *

Zip Code: *