Lip Sync Entry Form

ACTS FOR 2017 ARE SET! If you would like to be considered, fill out the contact form – if spots are available the organizer will contact you.

Performers must be 18 or older. Acts can consist of 1 or more performers, entry donation is a minimum $50 (you can donate more – highest entry donation gets to choose their performance slot). Complete and submit the form below. Donation may be made by check, cash or credit card.

    Group or Act Name (required)

    Your Name (required)

    Your Email (required)

    Telephone Number (required)

    Number of Participants

    Payment Method

    Song Choice #1 - Song and Artist

    Song Choice #2 - Song and Artist (If Choice #1 is not available)

    Song Choice #3 - Song and Artist (If Choices #1 and #2 are not available)

    Group Introduction


    To make your donation, we accept check (to the Leukemia and Lymphoma Society), cash, credit card/paypal (click Donate button below).  NOTE: Credit Card/Paypal Donations are sent to the organizer’s Paypal account – but, all funds, after expenses will be submitted to the Leukemia and Lymphoma Society – and are tax deductible – please contact organizer for a receipt.