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About  |  Register |  Rules and Regulations

Each member must submit a seperate registration form.  Please fill out the form below one member at a time.  For assistance filling out the form and packet please call the Mall Office at (239) 948-3766.

Online Registration Form

Tell us about the group

 Ages - 13 and Under Ages - 14 to 20

Tell us about the group members

   I hereby acknowledge the above information is true and correct and that I have read and understand and agree to the rules and regulations established for the contest, of which I have a copy. I also have no objection for the Sponsor to use any of my photos, videos and/or material for publicity purposes and that I will undertake to indemnify the Sponsor’s and/or any other unmentioned related/unrelated parties against all liabilities for death, personal injury (either fatal or otherwise), loss or damage to property and/or any other losses, damage, cost and expense whatsoever and however cause in the duration of my participation in the Miromar Has Talent contest. I also certify that I am in good health and physically fit to participate in this event.