APPLICATION

CAC Young Performers Showcase – PIANO EXHIBITION

* A $25.00 application fee is required at time of application

* Registration fees are NON-REFUNDABLE

* Incomplete applications will not be accepted.   Please print clearly and completely!

* Application & registration fee must be received NO LATER THAN October 15th, 2018

* To submit application and registration fee (checks made payable to CAC with performers name noted

on the check):

CARMEL ARTS COUNCIL

P. O. BOX 344

CARMEL, IN 46082

Or send by email:

CarmelYPS@gmail.com and pay using PayPal –> 

 

For more information/questions please email CarmelYPS@gmail.com

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REQUIRED RELEASE:

We hereby release the Carmel Arts Council, Piano Solutions, their directors, officers, and representatives of this showcase from any and all claims for damages or injuries sustained while participation in any activity of this showcase.  We also give the Carmel Arts Council and Piano Solutions permission to use photos, videos, and bios for promotion of the event.  I certify that I have read, understand, and agree to the terms and conditions.

(For showcase rules, visit www.carmelartscouncil.org)

PARENT/GUARDIAN SIGNATURE RELEASE

 

PRINT NAME: _________________________________________

 

SIGNATURE:­­­­­­­­­__________________________________________

 

Check the Appropriate Division as of August 1st:

____Grades 1 -2                      ___Grades 3-4                        ___Grades 5-6

____Grades 7-8                       ___Grades 9-10                      ___Grades 11-12

 

Performer’s Name:_________________________________

Date of Birth:  _________

Street Address:  ____________________________   Apt # ________

City: __________________,  IN      Zip____________

Parent/Guardian’s Name (please print clearly)_______________________

Parent/Guardian’s Email: ________________________Phone: (     )__________

Piano instructor/Teacher’s name: _______________________________________

Piano instructor/Teacher’s Email:________________________ Phone: (     )_________

ONLY ONE REPERTOIRE PIECE PER STUDENT.  (Original copy must be provided on day of performance):

Repertoire                                                                           Composer

__________________________________           ______________________________________

Check the Appropriate Level of Repertoire (please confer with performer’s teacher)

[ ] Early Elementary                     [ ] Elementary                 [ ] Late Elementary

[ ] Early Intermediate                 [ ] Intermediate              [ ] Late Intermediate

All Rights Reserved