2012 talent show

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					                            1511 E. Livingston Avenue Columbus Ohio 43205 (614 258-4633)

JuneteenthOhio 2012 Talent Show Registration Form
Registration Fee $100.00 Deadline June 1, 2012 – First 30 applicants only!

                                     MAIN CONTACT INFORMATION
Telephone:            day                                         evening

                                         PERFORMER INFORMATION

Name                                      x
                                         Ohio County ?                         E-mail Address

                                                ACT INFORMATION
Headline Stage Name:
Type of Talent:                                      Approx. Length of Performance:

              Poetry/spoken word                        Hip hop

       Inspirational/song                               Juneteenth history

              Comedy                                    Other

I have read the attached Rules & Regulations, and agree to abide by them.

Signed: _____________________________________________                  _____________________________
        Authorized Signature                                            Date

                  Make check or money order payable to JuneteenthOhio Festival.
                        Mail or drop off registration to address listed above
        Call 614-258-4633 for questions, or visit the website: www.JuneteenthOhio.net.


1.    Performers will compete for the Grand Prize of $1,000.00 dollars or total pot/amount below this value
      collected! Winner/Winners will be paid 30 days after the contest is completed. Prize money can be
      picked up at Ujamaa Bookstore 1511 E. Livingston Avenue Columbus Ohio 43205

2.    The talent show will take place on Saturday June 16th, 2012, main stage. Beginning at 3:00pm

3.    All performers must be residents of the State Of Ohio.

4.    No refunds! No exceptions!

5.    All performers must be at least be seven (7) years of age on the date of the Talent Show.

6.    Only one registration per performer/group is permitted. This pertains to all age groups. A group or
      performer can only register in one performance.

7.    JuneteenthOhio retains the right to refuse any entry, or terminate a performance that conflicts with the
      spirit and theme of the Festival. In the event a performance is cancelled while in progress, the
      performer's registration fee will not be refunded.

8.    All performers must sign in at the information booth one hour before their performance. Failure to do
      so will result in the performer's time slot being moved to the last available slot, or the performer's
      performance being cancelled. In the event the performance is cancelled, the performer's registration
      fee will not be refunded.

9.    Audio equipment, speakers, and microphones will be available to performers.             Any additional
      equipment must be provided by the performer, along with needed technicians.

10.   Neither JuneteenthOhio nor its sponsors will be responsible for loss of damage to personal property
      belonging to, or in the care of the performer.

11.   JuneteenthOhio retains the right to videotape all performances. Such videotape will be the sole
      property of JuneteenthOhio, and may be used in promotions related to JuneteenthOhio.

12.   The 2012 Talent Show winners may be contacted to be a main stage performer at the 2013
      JuneteenthOhio Festival, and a judge for the 2013 Talent Show.

13.   The prize winners are solely responsible for all taxes levied or assessed on the cash prizes. The prize
      winners will be required to show proof of age and residency.

14.   Employees of Alkebulan, Inc., UJAMAA Bookstores, Soul2Soul talkradio.com independent contractors,
      and members of the employees' immediate families are not eligible to participate.

15.   You will be asked to distribute/pass flyers promoting the Juneteenth Ohio talent

        Call 614-258--4633 for questions, or visit the website: www.JuneteenthOhio.net.
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