Performers name:____________________________________ Age__________(must be 16 or under)

A maximum of 6 people per group is permitted. Each performer must complete an application form. All forms should be
submitted together. Maximum stage size is 20ft x 10ft.
Address:___________________________________________________________________________________________
__________________________________________________________________________________________________
School:____________________________________________________________________________________________
Telephone:(Home)_________________________Telephone(mobile)___________________________________________
Email:_____________________________________________________________________________________________
(All correspondence will be via email, please ensure you check all emails)
Act: Dance

Vocal

Instruments

Other

Name of act:________________________________________________ Number of people in act_____________________

Please note that any instruments or props etc must be provided by the act, including amp cables, any other equipment
needed.
Please ensure you have your backing music on an Ipod, smart phone or similar device
Number of microphones needed:_________
APPLICATION FEE
An application fee of 5.00 per person applies and should accompany your application. Payment can be made by cheques
made payable to Centre Point Trust. Cash payments to be made in person only. Card payments can be made over the
telephone or by completing the slip below (this will be safely destroyed once payment is made).
Terms and conditions apply: On signing this form you are consenting to photos and video being taken and used publicly.
Please post your application to Centre Point Trust, Le Hurel, La Pouquelaye St Helier, JE2 3FW or email: jkgt@cpt.je.
Booking is not confirmed unless payment is made.
st

Closing date: 31 March 2015, late entrants will be charged 10 per child
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------Credit/Debit card payment: VISA/MASTERCARD/MAESTRO/DELTA
Card Number:

Start Date:
M

Expiry Date:
Y

Issue # :
Y

Security Code: