Are you/your participants registered for the AKKA 2016 WKC? *
Program Title: *
Program Type: *
Program Description (not more than 120 words): *
Program Duration (in minutes): * Please refer to the program submission rules for duration requirements @ https://akkaonline.org/2016/programs/participation-rules/
Number of Participants (only numeric up 99 can be accepted): *
Participant Name (if it is solo performance): *
Group Performance Names (if it is group performance document all participants names here separate by semicolon): *
Are participants taking part in additional programs: *
Participant Phone: *
Participant Email: *
City: *
State / Province: *
Postal / Zip Code: *
Country: *
Association representing: *
Select age range and the number of the participants (multiple choice): * For e.g.: If you have 7 people between the age range of Big Kids - 11 to 15 Years, select the button under 6 - 10 ppl. Kids - 5 to 10 Years:
Previous performance audio/video/document links: *
We are looking for audio/video/documents links from the past performances to assess the quality and deliverability of the program. Please provide YouTube video links or website url reference below
Please accept the terms and conditions before proceeding: *
I acknowledge that this large public event is a place where people from all walks of life are going to be gathered in a confined space. It carries with it the potential for death, serious injury and property loss. The risks include, but are not limited to: actions of other people including, but not limited to, participants, volunteers, spectators, audience, event officials, event monitors and/or producers of the event; weather, and/or other natural conditions. I hereby assume all of the risks for myself and on behalf of my team for participating in this event.I certify that I am physically fit, have sufficiently trained for participation in this event and have not been advised otherwise by a qualified medical person. I acknowledge that this Accident Waiver and Release of Liability (AWRL) form will be used by AKKA WKC 2016 and the sponsors of the event in which I may participate and it will govern my actions and responsibilities at aid event. In consideration of my application and permitting me to participate in this event, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) Waive, release, and discharge from any and all liability for my death, disability personal injury, property damage, property theft or actions of any kind which may hereafter accrue to me or my traveling to and from this event, THE FOLLOWING ENTITIES OR PERSONS: AKKA WKC 2016 and their organizing teams, directors, volunteers, sponsors, representatives and agents. (B) indemnify and hold harmless all entities or persons mentioned in this paragraph from any and all liabilities or claims made by other individuals or entities as a result of my actions during this event. I hereby consent to receive medical treatment that may be deemed advisable in the event of injury, accident, and/or illness during this event. I understand that I and my team will act professional and conduct ourselves prior, during, and after the event. I further understand that I may be asked to vacate the premises if my conduct doesn't conform to standard and respectable human behavior.
Please accept the talent release conditions before proceeding: *
I authorize the AKKA WKC 2016 to make use of my appearance on my program.I understand that I won't receive any compensation for this appearance. AKKA WKC 2016 shall have the complete ownership of the program. I give the AKKA WKC 2016 the right to use my name, likeness, and biographical material to publicize the program and the services delivered during the program. AKKA WKC 2016 may: (1) Photograph me and record my voice and likeness for the purpose of theproduction mentioned above, whether by film, videotape, magnetic tape, digitally or otherwise; (2) Make copies of the photographs and recordings so made; (3) Use my name and likeness for the purposes of education, promotion or advertising of the sale or trading in the photographs, recordings and any copies so made. (4) Telecast live or at a later time on any broadcast media across the world.I further understand the master copy remains the property of AKKA WKC 2016 and that there will be no restrictions on the number of times that my name and likeness may be used.