Make Music Day 2022 Live Performance Interest Form

Name(Required)

First Last

Email(Required)

Phone(Required)

Name of Song(Required)

Instrument?(Required)

Equipment Needed

Teacher(Required)

Store Location(Required)

Signature - All entries must include signature. By signing this and uploading a performance video or audio, you are granting Menchey Music Service permission to use your likeness or the likeness of your child in a photograph or video in any of its publications, including web-based publications. (under 18 needs parent/guardian signature)(Required)