Full Name

  Gender (Male/Female)

Age(s) of performer(s)

  Street Address

  City/State/Zip

  Phone (area code first)

  E-mail address

  If a Group, number of performers.

  Name of Act

                                Description of Act

By submitting this form I hereby release the Goose Festival Committee, the City of Fennville, the Fennville School District, officers and or agents whose property and personnel are used, from all liabilities for any injuries or damages my child may suffer because of their participation in Goose Festival Kid's Talent Show.