April 23, 2015 7:00 p.m. Registration begins at 6:30 p.m. Northridge High School Auditorium Middlebury, IN Entries due April 17, 2015 2015 4-H Performing Arts Entry Form Name of Act_______________________________________________ Club ______________________________________________________ 4-H Member in Charge _______________________________________ Address___________________________________________________ Number of performers __________ Phone _____________________ Names of Performers___________________________________________________________ __________________________________________________________________________________________ Give Brief Description of Act_____________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________ __________________________________________________________________________________________  All performers must be current 4-H members (Mini 4-H members are also allowed).  All performers agree to be video taped and photographed. Categories (check one) □ Group Act □ Curtain Act (Musical) Number of Performers: Five or more Performance Time Limit: 5-8 minutes □ Curtain Act (Non-Musical) Number of Performers: 1-4 Performance Time Limit: 3-5 minutes Return Entry Form to: 4-H Department Purdue Extension Elkhart County 17746 County Road 34, Ste E Goshen, IN 46528-6898 or email copy to: [email protected] Number of Performers: 1-4 Performance Time Limit: 3-5 minutes □ Clover Division (Grades 3 -5) □ Junior Division (Grades 6 – 8) □ Senior Division (Grades 9 – 12) (If multiple performers, check division of oldest performer.) Check if you will use: □ CD (The track # must be noted and your groups name.) □ Accompanist □ Electrical Connection Purdue University is an equal access/equal opportunity institution.