Young Magician Competition – The Magic Circle

Name *

First

Last

Stage Name *

Email *

Landline

Please enter a landline telephone number

Mobile *

Please enter a mobile number

Date of Birth *

Month of Birth *

Year of Birth *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Parent / Guardian name *

I agree to be responsible for this competitor during the Competition

Parent & Child Agree *

Declaration I certify that the above information is correct. I agree to abide by the rules and conditions of the competition and to accept the Judges' decision as final. I agree to being photographed and video recorded. My act may be included in any video of the Competition.