CANSA Socialite Entry

* indicates required field

Participant's Full Name*

Participant's Email

Participant's Cell Number

Select a Category:
ModelingSingingDancingActing

Select an age category if you are entering the Modeling category:
n/a3-67-1213-19

Select an age category if you are entering the Singing, Dancing or Acting category:
n/a7-1516+

Parent/Guardian's Full Name*

Parent/Guardian's Email*

Parent/Guardian's Cell Number*

Your Province*
—Please choose an option—Eastern CapeFree StateGautengKwazulu NatalLimpopoMpumalangaNorth WestWestern Cape

I, the Parent/Guardian, accept the terms and conditions of the competition*
Yes

I accept correspondence from CANSA and Brand Partners:
YesNo

Message (optional)

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