Big Break Registration Form

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* Required Information
Name of Artist/Group: *
Main Contact
Name & age: *
Address:
Suburb/City:
State:
Postcode:
Phone AH: *
Phone Mobile:
Email: *
Web Page:
Artist/Group/Band Details
Number of Performers:
Performers Names & Ages:
Limited Crew Tickets will be issued.  Tickets for friends & family are just $5 each.
Instruments Played:
Equipment Requirements:
 
Promotional Material
Please support your application with some Promo Material.
Send CDs, photographs to Big Break Coordinator, PO Box 230, The Basin 3154
Act Biography:
Give a brief and interesting description of your act/performance for inclusion in the program.
(no more than 50 words).
Security
Please type the two words below with a space in between to show us you are human.