Amateur Burlesque - Performer Registration

Temptation and Tease Cabaret!

Amateur Burlesque Night
Performer Information
Performer/Group Name*
Legal Name (Please provide name of the main contact)*

First NameLast Name
Age/ Age Range*
Please select the pronouns you use.*

She/Her/HersHe/Him/HisThey/Them/TheirsNot Listed (Please share in box below)No Preference
Please share your pronouns
Pronouns are the part of speech used to refer to someone in third person. We want to know how to respectfully refer to you.
Email*
example@example.com
Phone*
Emergency Information
Emergency Contact's Name*

First NameLast Name
Relationship*
Phone:*
Do any of the performers in your act have any allergies, chronic illness, or medical conditions that organisers should be made aware of? If yes, please describe.
Your Act Details
Number of Performers*
Please provide names and pronouns of all performers involved:
ex: Joe Bloggs, He/Him/His
Type Of Act*
Style and Discipline
Theme:
If currently unknown please ensure you email details by 1st June 2024.
Equipment/Props Required?*
Performers are responsible for the provision and set up of any props/equipment used.
Length Of Performance?
If currently unknown please ensure you email details by 1st June 2024.
Music Choice:
If currently unknown please ensure you email details by 1st June 2024.
Please provide an image of your act that can be used on social media for promotional purposes. (You can send an updated image prior to 1st June 2025 to info@creative-heights.co.uk)*
Please provide a bio of your act that may be used for advertising purposes and/or used to introduce your act.*
Terms and Conditions
* By submitting this form you are confirming your act is available to perform on Saturday 21st June 2025

* All performers are participating in the event on a voluntary basis, without payment for services.

* All proceeds from the event will be split between Northcote Horse Centre and Creative Heights 'Create' fund.

* Performers are required to help promote the event and assist in selling spectator tickets once they become available.

* The performance space is approximately an 8m diameter ring.

* Performers are responsible for the provision and set up of all props and equipment.

* Performance music must be sent in MP3 format to info@creative-heights.co.uk by 1st June 2025.

* Provisions must be made by the performer to clear away any props after your act.

* The backstage area is very small with limited lighting.

* By participating in the event you are declaring you are aware of any risks involved with your act and are responsible for your own safety at all times.

* If your act involves fire or working at height, you will need to provide a full risk assessment and appropriate public liability insurance coverage.

* If you have any concerns or questions please email us at info@creative-heights.co.uk or call 07919133355 before the event as we may be unable to find solutions to any problems we find out about on the day!
Confirmation BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Please read the declaration and sign below.

I have read and understand the terms and conditions, and by submission of this form wish to be considered in the events above. I hereby, for myself, my heirs and my executors, waive and release any and all rights and claims I may have for damages against Creative Heights and/or their sponsors, agents or representatives for any injuries which may be suffered or damages/loss of property by attending, participating in or travelling to or from said event by submission of this form. Participation or attendance constitutes authorisation to use and reproduce any and all photographs, negatives or positives, proofs and prints taken during the event.
Signature*

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Temptation and Tease Cabaret!

Your Act Details

Terms and Conditions