Winners Recitals Online Registration Form | Elite International Music Competition

Performer Information

Teacher's Code

Performer's First Name

Performer's Last Name

Performer's Country

Performer's Street Address

Performer's City

Performer's State

Performer's Zip Code

Performer's Address

Phone Number

E-mail

Confirm Your Music Selection

Composer

Title (Op., No., mov., key)

Duration (e.g. 3:15)

Duration Seconds

Performance

Solo

Duet, Trio, or Ensemble

If playing duet, trio, or ensemble please name your co-performer(s)

Optional: Parent/Legal Guardian Publicity Authorization and Release

Elite Music Competition Corp. may distribute informational or promotional material, both electronic and printed, to the parents of current and/or prospective participants. These materials include, but are not limited to, newsletters, promotional brochures, development publications, regional, national, or international advertisements, and the company’s World Wide Web site.

I hereby certify that I am of legal age and I am competent to grant to Elite Music Competition Corp. the absolute and irrevocable right and unrestricted permission to use the name, likeness, image, voice, and appearance of my child named above, as such may be embodied in any photos, video recordings, audiotapes, digital images, and the like, in all company’s media types including, but not limited to, news releases, photographs, audiotapes, videotapes, internet transmissions, and any publication or news release that may be used by or for the company while my child is participating in the company’s media types identified above. I waive the right to approve or inspect the recordings, advertising copy, or material used in conjunction therewith and I acknowledge that I will not receive any compensation for the use of such images, video, likeness, etc. I hereby release and discharge Elite Music Competition Corp., its agents, representatives, and assignees from any and all claims and demands arising out of or in connection with the use of my child's name, likeness, image, voice, and appearance, including any and all claims for invasion of privacy, right of publicity, misappropriation or misuse of image, and defamation. I have read this release before electronically signing below and I fully understand the contents, meaning, and impact of this release.

Parent/Legal Guardian's First Name

Parent/Legal Guardian's Last Name

Date

Please type your first name initial and your last name as your electronic signature in the following box (for example, John Doe: JDOE) :

Signature

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Please fill out the form and click the Submit button at the bottom of the form. All fields marked with an asterisk (*) are required. After you click the Submit button you will be directed to a confirmation page where you can review the information you have submitted and choose a payment method. The recital fee can be paid by personal checks, certified checks, or money orders in the U.S. dollars, drawn on a U.S. bank, and made payable to Elite Music Competition Corp. or online via PayPal. If you choose to pay via PayPal, a $9 service charge will automatically be applied to your total. Late Registration Fee: $35

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