Karaoke FunFest Performance Release
And Registration Form

I agree to hold blameless and harmless Roadhouse Karaoke, owners of said building, Judges,
and any other person or entity associated with said performance from any claims, harm, pain,
suffering, or death as a result of my competing in the contest known as the Karaoke FunFest
Contest.

I also give complete and full rights and permission to use my name, voice, performance, still
photos, video, film, or TV promotions to the producers without receiving or asking for any
compensation. I have read and agreed to the posted rules of this contest. Must be over 18 years
of age to enter.

Contestant Signature: ________________________
____
Print Name: ___________________________________
Address: ___________________________________
City & Zip Code: ______________________________
Phone #: ________
_______________
Age: ____________
Email Address: ______________________________
Song You Will Be Singing: ___________________________

Paid: ____________________________

All music owned and provided by Roadhouse Karaoke of Beavercreek, Ohio (except where
audio/music is provided by contestants)

Registration Fee is $20.00. If you register prior to
Friday August 13, 2010 it will be $15.00