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Talent's Age

Talent's Age: - Age - 78910111213141516171819202122232425262728293031323334353637383940414243444546474849505152535455565758596061626364656667686970

First/Last Name:

Gender: - Gender - Male Female

Email:

Phone:

State, ZIP: - ST -AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY

I confirm that I am the legal Parent/Guardian of the named Talent who is under the age of 13.

Parent's Name: