ENTRY FORM 2017 - OR enter and pay on line at www.kiwanismusicfestivallondon.com
PAPER &/OR ELECTRONIC ENTRIES CLOSE SATURDAY, DECEMBER 3,2016 at 5:00 pm.
Make cheque payable to: The Kiwanis Music Festival of London Inc.  Your cancelled cheque is your receipt. 
Mail cheque & entry form/s to:  Kiwanis Music Festival of London,  P.O. Box 50008, London, ON  N6A 6H8.
AN ENTRY FORM FOR EACH CLASS IS REQUIRED.

Class Number

 

 

Competitor:  1st Name

Last Name:

School & Board

 

Class Name: (for example)  – Vocal, Female, 12 yrs & U, Sacred;  OR  Piano, 16 yrs & U, Romantic;  OR Violin, open etc. etc.

 

Address No.

 

 

Street

City

Postal Code

Your E-Mail

 

Phone

 

 

Other Phone

Birth Date

Age

TEACHER: (Check one) Private  €   School  €

First Name_________________________________

 

Last Name _________________________________

Address

_________________________________________________

 

P.C.________________              Phone _______________

 

Email  ___________________________________________

Competitor's

Music Grade:

Number of Performers

Accompanist Name:

Own Choice Selections                                         (Performance time in minutes for scheduling)

Title

Composer

Minutes

1.

 

 

2.

 

 

3.

 

 

Duets, Trios, Quartets & Quintets (Please list performers in the space provided.)

Surname

First Name

Instrument

D.O.B.

1.

 

 

 

2.

 

 

 

3.

 

 

 

4.

 

 

 

5.

 

 

 


 

Please list all other classes entered to help us avoid conflicts.

Class No.

Class No.

Class No.

Class No.

Class No.

Class No.

Class No.

Class No.

Class changes will not be permitted. It is the responsibility of the Competitor, Parent and Teacher to read ALL RULES
and to enter the correct class number/s.


 

 

Reminder to all participants, parents and teachers that all suggestions, complaints or protests concerning the Festival must be directed in writing to "THE BOARD".  Decisions of the adjudicators are final.  I hereby certify, having read the rules and regulations for 2016, that this entry complies with all conditions. 
N.B. Privacy Legislation requires a signature in the area below.

Competitor Signature:______________________________________

 

Parent Signature: ________________________________

 

Teacher Signature: _______________________________

I give permission for my child’s name, ____________________________________________,
and school to be included on the Kiwanis Music Festival website and performance program.
Parent's Signature/Guardian ………………………………….. 
                                                 OR

 Entry Fee

 

 

$

Paper entry fee
 _______classes @ $3.00 each
 

I do NOT give permission for my child’s name, __________________________________,  to be included on the Kiwanis Music Festival website and performance program.
Parent's Signature/Guardian …………………………………….

Festival Program 2016

_______ @ $5.00:

$

 Please refer any questions regarding completion of

this form to the Festival Administrator.        Tel. 519-432-5183         

Donation

$

 

 or email  cvcleland@rogers.com

 

Total Enclosed

$