Name *

First Name

Last Name

Phone *

Country

(###)

###

####

Personal, Business, or Work Address *

For identify verification purposes only. You may request your data be deleted and we will.

Address 1

Address 2

City

State/Province

Zip/Postal Code

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Songs you are interested in

if applicable

MS BS Extra

SSs

Nearly a Day of My Life

2x100

3x100

Songs with Vocals

Keyboard Improvisation

Other

Show Location *

Address 1

Address 2

City

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Date of Show *

MM

DD

YYYY

Beginning of Show Time *

Hour

Minute

Second

AM PM

Verification and Agreement *

Check boxes, if you agree to the following:

I'm a real person with interest in a show.

I won't record, and will make every effort to prevent recordings of the show, including but not limited to cameras, cell phones, hidden cameras, or sound recording devices.

I'm not trying to exploit or take advantage for personal gain.