Talent Competition Registration Form Registration Form If you are human, leave this field blank. Name First Last Last Email Birthdate Address Telephone Number Alternate Telephone Number Emergency Contact Name Emergency Contact Phone Today's Date * Waiver * Check to Sign the Waiver ( must be signed in order to participate) By checking this box, I hold St. Victor Parish and the Diocese of San Jose, its staff and volunteers harmless from any claim of injury, sickness, illness, or damage that the performer / my child may suffer or sustain during the activity listed, with exception to injury or damages arising out of the sole negligence of the Parish or Diocese of San Jose. I attest that the performer / my child is physically fit to participate in this event. In the event the performer / my child becomes ill or injured, I hereby consent to whatever X-ray, examination, medical treatment or hospital care considered necessary in the best judgement of the attending physician and performed by or under supervision of a member of the medical staff of the hospital facility providing the treatment. I am not aware of any medical condition which would render it inappropriate for the performer / my child to participate in any such activity. Photo / Media Consent Select to Agree and Sign Photo/Media Consent Select to Opt Out of Photo/Media Consent Occasionally, pictures, recordings, interviews, videotapes, or film are taken of youth during events and gatherings. We would like to be able to use these photomedia medium for newsletters, flyers, television, and the parish/diocesan website. We will not use any last names if posted. Concerns about published pictures should be expressed to writer / webmaster and will be promptly dealt with. I/We the parents/guardians of the performer/s authorize and give full consent, without limitation or reservation, to the Parish/Diocese of San Jose to publish any photographs, recordings, film, or interviews in which the above named performer/s appear while participating in any program with the Parish/Diocese of San Jose. No compensation is to be given. Additional Message Submit Click HERE to pay your registration fee online.