Legal Name *

First Name

Last Name

Stage Name

First Name

Last Name

Mailing Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Birth Date *

MM

DD

YYYY

Emergency Contact

First Name

Last Name

Emergency Phone

(###)

###

####

EMAIL CONSENT *

I agree to receive emails from Fornication.

SMS CONSENT

I agree to receive text messages via SMS.

PHOTO PERMISSION

I grant Fornication the use of my image(s) for promotional use

PROMOTION AGREEMENT

As a Performer I agree to create and post a minimum of 2 “original” posts per week on my social media in the 30 days leading up to each party I am scheduled on.