Artist Registration

To register as an artist, please take the time to fill out the information below.

First Name

Last Name

Email

Mobile

Address

Town

Postcode

Region

What region are you from?GascoyneGoldfields-EsperanceGreat SouthernKimberleyMid-WestPeelPilbaraSouth WestWheatbeltInterstate

What is your age range?

Choose your ageUnder 1818 - 2425 - 3435 - 4455 - 6465+

Company Name

What is your gender

Choose an optionMaleFemaleOther

Do you identify as Aboriginal or Torres Strait Islander?

Choose an optionYesNoPrefer not to say

Are you a member of the Country Music Club of Boyup Brook?

Choose an optionYesNo

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