Selena Contest Registration

Name *

First

Last

Age *

Birth Date *

Parent / Guardian Information *

First

Last

(Required if participant is under 18)

Address *

City *

State *

Zip Code *

Phone Number *

Preferred Song for Performance *

Please provide the exact song you will perform. This helps our DJ prepare your track in advance.

Emergency Contact Name *

First

Last

Relationship to Participant *

Phone Number *

Photo & Video Release Agreement *

I understand and agree to the photo and video release terms.
I understand all contest rules and agree to follow staff instructions.

By entering the Selena Look-A-Like Contest, participants agree to be photographed and recorded during the event. The festival and its organizers may use photographs and video recordings of participants for promotional, marketing, and media purposes without compensation.

Number 18) Phone

Participant Parent/Guardian Signature (if participant is under 18) *

Date *