Super Smart Kids Entry Form

"*" indicates required fields

Name of Contesting Kid*

First Name Middle Name Last Name

Age of Contesting Kid*

Gender*

Male

Female

Indicate Sex of Contesting Kid

Current Class*

Select your current class in school.

Do you have any special talent(s)?*

Yes

If Yes, please list them in the fields provided below*

Why do you want to participate in this talent show

Parent's (Guardian's) Name*

Title First Name Last Name

Parent's (Guardian's) Occupation*

Select as appropriate

Please specify your Occupation*

Email*

Enter Email Confirm Email

Phone*

Location/Region*

Select current residential state/region

ZIP / Postal Code*

Enter 6 digit ZIP / Postal Code

Image*

Accepted file types: jpg, jpeg, png, gif.

Upload a clear and sharp image of the child being registered.

Entry Fees

Price:

Registration fees for single child