***IMPORTANT***
To be eligible to compete in the Schuylkill County Idol 7 Contest, this registration form must be filled out in its entirety and returned to Schuylkill Mall Customer Service by noon on June 30th.
You must also submit a recent photograph of yourself with this registration.
(Photos may be used during or after the contest, and will not be returned.)
Contestants may NOT enter if you have been named Schuylkill County Idol in any prior year’s Schuylkill County Idol competition.
Name: _______________________________________________________________________
Address: ______________________________________________________________________
City/State/Zip Code: ___________________________________________________________
Home Phone : (______) ___________________ Cell Phone: (______) __________________
Date of Birth: _____________________________________
Email Address: ________________________________________________________________
Nickname: ____________________________________________________________________
Are you still in high school/college? ___________ Yes __________ No
If yes, please list high school/college: _____________________________________________
Do you have a job? __________ Yes __________ No
If yes, where are you employed and what is your title? ________________________________
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Do you have any formal singing training? __________________________________________
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Where have you performed previously? ____________________________________________
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What is your favorite song to sing? ________________________________________________
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What is the 1st concert you ever went to? ___________________________________________
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What is the most recent concert you’ve gone to? _____________________________________
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What talents do you have besides singing? _________________________________________
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What are your goals in life? ______________________________________________________
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What are your hobbies/interests? _________________________________________________
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What school/community/professional groups do you belong to? _______________________
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Who is your Idol? ______________________________________________________________
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Why should you be the “Schuylkill County Idol”? ___________________________________
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Please answer each question completely and sincerely. Answers may be shared with the public during or after the contest. Return completed registration forms along with a recent photograph of yourself to Schuylkill Mall Customer Service or mail it to the Schuylkill Mall Management Office at 830 Schuylkill Mall Road Rt. 61 and I-81 in Frackville, PA 17931.
Deadline for entry: June 30th at noon
PLEASE READ THE FOLLOWING CAREFULLY: In consideration for being permitted by Schuylkill Mall to audition to become the “Schuylkill County Idol” (the “Contest”) I agree as follows:
1. Neither I nor anyone in my immediate family nor anyone living in my household, is an employee, officer, director or agent of the following: (a) Empire Schuylkill L.P.(b) any person or entity involved in the development, production, distribution or other exploitation of the Contest.
2. I understand and agree that Schuylkill Mall reserves the right to render ineligible any person who Schuylkill Mall determines, in its sole discretion, is sufficiently connected with the production, administration, judging, or distribution of the Contest such that his or her participation in the Contest could create the appearance of impropriety.
3. I am/will be a Schuylkill County resident for at least 6 months prior to June 30th and am presently between 16 and 30 years of age. I agree to provide valid proof of age and citizenship upon request. If I am under 18, I must have a parent or guardian present and they must sign this registration form and any other documents as necessary if I wish to participate and remain in the Contest.
4. I have never been charged with a felony or misdemeanor, other than minor traffic or parking violations, nor have I ever had a restraining order entered against me. I agree to abide by all U.S. laws during the Contest.
5. I represent that I do not have a signed contract or representation agreement with a recording manager or agent, or a modeling or talent agent.
6. If selected as one of the finalists, I agree that I will be available to meet with mall management at a time designated by them before the Quarterfinal round on Tuesday night, July 7th .
7. If selected as one of the finalists, I agree that I will be available to participate in all future elimination rounds ( July 7th, 14th, 21st, and 27th) and to perform at the Schuylkill County Fair on Saturday, August 1st (exact time will be discussed with Schuylkill County Fair officials upon appointment of the winner).
8. I understand and agree that selection of the finalists shall be made at Schuylkill Mall's sole discretion based on such criteria as Schuylkill Mall shall determine which may be subjective. All decisions made by Schuylkill Mall regarding the selection process are final and not subject to challenge or appeal. Schuylkill Mall reserves the right to change the selection process and eligibility without notice.
9. By submitting this application, I irrevocably consent to the use and reuse by the Schuylkill Mall and each of their current and former employees, agents, officers, directors and shareholders (collectively "Releasees") of my performance, voice, actions, likeness, name, appearance, biographical material, and any information contained in my registration form to be a contestant in the Contest or in any materials submitted by me in connection with my registration form (collectively "Likeness") as edited, altered, or modified by Schuylkill Mall in any and all media now known or hereafter devised, worldwide in perpetuity, in or in connection with the Contest. I agree the Releasees may use all or any part of my Likeness, and may alter or modify it regardless of whether or not I am recognizable. I further agree that Releasees may use my Likeness in connection with any promotion, publicity, marketing or advertisement for the Contest. I grant the rights hereunder whether or not I am selected to participate in the Contest in any manner whatsoever. I release Releasees from any and all liability arising out of the use of my Likeness, participation in the Contest (including, without limitation, any claim that such use invades any right of privacy and/or publicity), and shall indemnify and hold Releasees harmless from any claim, action, loss, damage, expense or injury arising out of or in any relation to my participation in the Contest. I understand that I will not be paid any money for giving Releasees these rights, or for signing this agreement. Furthermore, the Schuylkill Mall shall not be obligated to use my Likeness in any form or to provide a credit or acknowledgement to me or to pay me for the use of my performance or Likeness. I agree not to make any claim against Releasees as a result of the use of my Likeness (including, without limitation, any claim that such use invades any right of privacy and/or publicity).
10. If chosen as the Contest winner, I agree to provide Schuylkill Mall with two additional performances through the end of 2010 at no cost. Performances will take place at Schuylkill Mall at a date and time agreed upon by both parties.
PLEASE READ, SIGN, AND DATE THE FOLLOWING STATEMENT:
I hereby acknowledge that: (i) I have read and agree to be bound by the above terms and conditions; (ii) I have answered the questions above honestly and accurately; (iii) if any of the information I have provided herein is found to be false, this will be grounds for my dismissal from the "Schuylkill County Idol" Contest, if selected; (iv) All decisions concerning finalists are final and not subject to challenge or appeal; and (v) These rules and requirements are subject to change at any time. I have read, understand and agree with the foregoing.
SIGNATURE:____________________________________ DATE: _______________
IF REGISTRANT NAME ON PAGE ONE OF THIS FORM IS UNDER THE AGE OF 18, THE PARENTS OR LEGAL GUARDIAN OF SUCH PERSON MUST SIGN BELOW.
I hereby warrant that I am the parent and/or legal guardian of _______________________ who signed the foregoing Registration/Release, that I have caused said individual to execute this Registration/Release, that I will indemnify you against all claims, liabilities, and expenses with respect to this Registration/Release, and that, knowing of your reliance hereon, I agree to cause said individual to adhere to all of the provisions of the Registration/Release. If requested by you, I will cooperate with and assist you in obtaining court approval of any and all agreements my child or ward may enter into with respect to the Contest.
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SIGNATURE OF PARENT OR GUARDIAN
PRINT NAME: _____________________________ PHONE #: ________________
ADDRESS: _____________________________________________________________
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