SEAM 2005 Convention Contest Application Form


	SEAM 2005 Convention Contest Application Form

*** Seam 2005 Contestant Application Form ***

Please print.

Applicant's Full Name: _________________________________________________________

Stage Name (if any): _________________________________________________________

Street Address: _________________________________________________________

City: _____________________________________ State: _____________

Postal Code: ________________________ Country: ____________________________

Telephone Number: _________________ E-mail address: ________________________

Date of Birth: ____________________________

Are there any pyrotechnics (flames, sparks, or smoke) in your act? _____
If yes, what type? _______________________________

I am entering (check all that apply):
Adult Stage Competition ( )
Youth Stage Competition ( )
Close-Up Competition ( )

I understand that, in order to compete, I must be fully registered as a Magician at the SEAM 2004 convention. I understand that there is a $5.00 entry fee (made payable to the "Space City Magic Club") for each competition. I understand that the winner of the Adult Stage Competition may be expected to perform on the Saturday evening Show.

I certify that the foregoing information is true and correct, that I have read and agree to abide by the Contest Rules and Procedures, and that no knowingly unauthorized use of intellectual property will be included in my contest performances. I agree to indemnify and hold the organizers of the SEAM harmless for any damages, expenses or losses it may incur by reason of claims made against me as a result of my participation in this contest, regardless of the merit of any such claims. I agree to be bound by all decisions of the Contest Judges. I agree that any untrue statements made by me or a breach by me of any covenants contained herein shall be grounds for disqualification.

Amount Enclosed: $ ___________
(Please make checks payable to "Space City Magic Club")

_________________________________________________________________
Signature Date

_________________________________________________________________
Signature of legal guardian (if the applicant is under age 18) Date

Mail to: Dean Carter, SEAM Contest Chairman
115 Freedom Way
Madison, AL 35758

256-726-0278

### Form End ###

e-mail process:
Start your own email message using your own email system
Highlight this form (starting with the text "*** Seam 2005 Contestant Application Form *** through ### Form End ###")
then copy and paste it into your email body (feel free to shorten/eliminate the underlines)
then make the appropriate entries onto the form (in your email body)
then copy and paste the following address into your email message "send to" area: Dean.Carter@msfc.nasa.gov
then copy and paste the following into the "subject" line of your message: SEAM Contest Application
then click your email "send" button

Note: not everyone has Microsoft Outlook so the above process should allow anyone to email this form.

Note: If you email the application you must deliver the $5 entry fee directly to the Contest Chairman (Dean Carter) at, or prior to, the Pre Contest Meeting.