RAINELLE CENTENNIAL IDOL - REGISTRATION FORM NAME:____________________________________________________________ ADDRESS:_________________________________________________________ __________________________________________________________________ PHONE NUMBER(s):________________________________________________ DATE OF BIRTH:____________________________________ AGE:__________ Song Title

#1_______________________________________________________ Song Title #2_______________________________________________________

DEADLINE FOR REGISTRATION IS MARCH 25, 2013

1) There is a $20 REGISTRATION FEE to enter competition. This fee does NOT guarantee a win. It only guarantees a reserved spot in the competition. The $20 fee is NOT refundable! You must register no later than MARCH 25, 2013. Please mail this registration form along with your $20 Registration fee to: Rainelle Centennial Idol If paying by check or money order, please make ATTN: Debra Davidson 645 Kanawha Avenue payable to: Town of Rainelle/RCI Rainelle, WV 25962 2) THIS COMPETITION IS ONLY FOR AGES 15-25. If you are not 15 years of age by the day of the competition, you will not be eligible to compete. If you are older than 25 years of age by the day of the competition, you will not be eligible to compete. THIS COMPETITION IS ONLY FOR RESIDENTS OF THE WESTERN END OF GREENBRIER COUNTY AND/OR HAVE A RAINELLE ADDRESS. 3) Please have 2 songs prepared, recorded on CD and ready to sing on day of Competition. Song #1 is for the first round and if you make it to the final round you will need Song#2. YOU ARE RESPONSIBLE FOR YOUR MUSIC! 4) This is strictly a solo vocal singing competition. No Groups & No Bands Allowed. Amateurs only. 5) Winner will receive the title RAINELLE CENTENNIAL IDOL 2013, $100.00, a trophy and a spot in the Rainelle Centennial Parade on April 27, 2013. 6) If you are under the age of 18, parental consent is required. 7) The Town of Rainelle or any other party affiliated with Rainelle Centennial Idol 2013 will not be held responsible for any injuries, stolen items, loss of music & any hurt feelings, etc. Enter at your own risk

Contestant Signature:______________________________________Date:_______ Parent/Guardian Signature: _________________________________Date:_______ (Needed if contestant is under the age of 18) Rainelle Centennial Idol 2013 will be on April 22, 2013 at 7:00pm. Location to be announced!