Caution: JavaScript execution is disabled in your browser. You may not be able to answer all questions in this survey. Please, verify your browser parameters.
Coffee for a Cause Registration Form
All teens are welcome to perform, whether it is a musical act, dramatic performance, poetry recitation, or other. Fill out the form to register. You will be contacted by a Youth Services Librarian to confirm.
There are 10 questions in this survey.
Registration Form
*
Name of Contact Person:
*
Address
*
City, State, Zip
*
Telephone Number
Please enter digits in format 000-000-0000
*
How many people will be performing in your act?
Only numbers may be entered in this field
*
Name of all participants AND phone numbers:
*
What type of performance will it be?
Choose one of the following answers
Solo act
Band
Poetry reading
Dramatic performance or short play
Comedy act
Other
*
Title of your act (as it will appear in the program):
*
Approximately how long is your act (in minutes):
List any props or equipment that you will need:
[Exit and Clear Survey]