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Alice in Wonderland Dance Production Auditions

Primary Contact First/Last Name*

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Child's First/Last Name*

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Primary Contact Relationship to Child*

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Date of Birth *

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Age*

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Primary Contact Home Phone*

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Primary Contact Cell Phone*

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Height*

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Gender *

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Female

Male

Current Dance School*

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Class Level*

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Primary Contact Email Address*

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Academic School*

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Current Grade Level*

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Street Address*

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City*

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Zip/Postal*

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Audition Video Link*

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Name(s) of any siblings auditioning:*

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Contact During Rehearsals:*

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TERMS OF PARTICIPATION AND RELEASE

The undersigned parent (or guardian) of Dancer hereby acknowledges reading and clearly understanding the rules and regulations involved with Dancer's participation in the Sacred Heart School for the Arts audition for ALICE IN WONDERLAND Dance Production and agreeing to follow these rules and regulations.

Media Release: I give my permission for photographs or video footage which includes my child or myself to be used for promotional purposes on television, newspapers, magazines or any other media.

Medical Release: I am aware that ballet dancing and the gymnastic exercise associated with it place unusual stress on the body and carry with them the risk of physical injury. On behalf of my child and myself, I assume the risk and agree that Sacred Heart School for the Arts, related entities of whatever kind or nature, successors, assigns, officers, directors, attorneys, agents and employees shall not be liable in any way for any injuries sustained or loss of property during attendance at Sacred heart School for the Arts activity or any of its related functions. Permission is granted for emergency medical treatment for my child / me.

Please list all relevant medical, developmental or other conditions that might affect your child’s audition today. I acknowledge that I have read, understand, and agree to comply with all above releases and all applicable policies and procedures of Sacred Heart School for the Arts.*

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Name of Dancer (serves as Signature)*

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Name of Parent (serves as Signature)*

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Date*

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Confirmation Email

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