Open Mic Performer Registration
Complete this pre-registration form to apply to perform. There is a 20 performance limit. You must submit your application by October 23, 2026.
Performer Information
Full Legal Name
*
First Name
Middle Name
Last Name
Stage Name / Group Name
Date of Birth
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Age
*
City
*
State
*
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Other
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email Address
*
example@example.com
Emergency Contact Name and Phone Number
*
Social Media Handles
Performance Details
Performance Category
*
Please Select
Vocalist/Singer
Singer-Songwriter
Spoken Word/Poetry
Comedy
Instrumental/Acoustic
Other
Describe Performance Type
*
If you are a group, list all the members names.
Solo or Group
*
Solo
Group
Performance Title
*
Original / Cover / Not Applicable
*
Original
Cover
Not Applicable
Brief Description of Performance
*
Estimated Performance Length (minutes)
*
Will you use a pre-recorded backing track?
*
Yes
No
Upload Backing Track
Upload a File
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Choose a file
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of
Instruments, Equipment, and Technical Needs
*
Age and Guardian Consent
Is the performer under 18 years old?
*
Yes
No
Parent/Guardian Full Name
*
First Name
Last Name
Parent/Guardian Phone
*
Please enter a valid phone number.
Format: (000) 000-0000.
Parent/Guardian Email
*
example@example.com
Parent/Guardian Consent
*
I consent to the performer’s participation and agree to follow the event rules
Other
Rules, Agreements, and Signature
Rules & Guidelines
Agreement to the Rules & Guidelines
*
I agree to the Rules & Guidelines
I understand and agree
Submission and Selection Acknowledgment
*
I understand that submission does not guarantee acceptance and LRDA will confirm selected performers
I understand and acknowledge that registration does not guarantee a performance slot
Voting Acknowledgment
*
I understand that winners will be determined by audience/fan voting using LRDA's official voting process
I acknowledge the official voting process
Photo/Video Release
*
I authorize LRDA to photograph, record, livestream, and use images/video/audio for event coverage and promotional purposes
I agree to the photo and video release
Typed Signature
*
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Submit Application
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