Stage Name* Full Real Name* Email* Mobile number* Address* What city & country should you be listed from*
Are you 18 old or older?* YesNo
Have you won any titles at a festival? If so, please list the name of the festival and title
Facebook page* Instagram*
Which category you are applying for* ContestNo contest
How do you want the MC to introduce you? (keep it short please)* Name Act* Enter the link / URL of the video of your performance* Duration of your act (MAX 5mn)* Music (name and artist)*
Starting on or off stage?* OnOff
Tech Info - please include lighting requirements and important technical details about your act* Costume colours* Act Set Up* Do you use any glitter, confetti, liquid or anything else that need to be cleaned up after your routine*
Attach photo (Please resize photos to 2MB)*
Attach PayPal Receipt*

This agreement releases Cuore e Burlesque Festival, Cuore e Burlesque a.s.d., Silvia Capannini and Cast Oro Teatro, from all liability relating to injuries that may occur {during activity and on location, on stage, off stage, back stage}. By signing this agreement, I agree to hold Cuore e Burlesque Festival, Cuore e Burlesque a.s.d., Silvia Capannini e Cast Oro Teatro entirely free from any liability, including financial responsibility for injuries incurred, regardless of whether injuries are caused by negligence. I also acknowledge the risks involved in circus, burlesque, dancing, and all live show performances. I swear that I am participating voluntarily, and that all risks have been made clear to me. Additionally, I do not have any conditions that will increase my likelihood of experiencing injuries while engaging in this activity. By signing below I forfeit all right to bring a suit against Cuore e Burlesque Festival, Cuore e Burlesque a.s.d., Silvia Capannini e Cast Oro Teatro. In return, I will also make every effort to obey safety precautions as explained to me verbally or by email. With this application I authorize the organization to use my image for advertising purposes in respect of good taste. I will ask for clarification when needed.
*** I fully understand and agree to the above terms ***(say yes)* YESNO

Signature: Please state your FULL NAME + STAGE NAME in Capital letters:*