AUDITION JULY 7TH OR 24TH

Auditions July 7th, July 14th, July 24th, July 31st

Competition Main Teams, Additional Teams, Dance Production "CIRCUS" and Theatre Production " Matilda" OR NUTCRACKER BALLET
Student Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Medical Concerns/Allergies
Parent/Guardian Name

First NameLast Name
Phone Number (Home)
Phone Number (Mobile)
Email Address
example@example.com
Parent/Guardian Name-

First NameLast Name
Phone Number
Email Address
example@example.com
Address for Child*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Emergency Contact

First NameLast Name
Phone Number

Sick Policy: Due to the new environment that we are under, no one will be allowed in the studio if presenting with any sort of illness. Students must stay home if they are sick, or if anyone in the household is sick, for the health and safety of our community. Any student coming to a program with any illness will be sent home.

I understand and agree with the above, in conjunction with the Guidelines and Policies given to me at the time of my initial enrollment. Ms. Marianne Power of Performing Arts Inc. reserves the right to make appropriate changes in the event of a printing error or changes due to covid restrictions.
LIABILITY RELEASE/WAIVER

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Ms.Marianne Power of Performing Arts inc while attending Winter camp. In exchange for the acceptance of said child’s candidacy by Ms. Marianne Power of Performing Arts Inc., I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Ms.Marianne Power of Performing Arts inc . and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from selected camp sessions. In case of injury to said child, I hereby waive all claims against Ms. Marianne Power of Performing Arts inc . including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the event. There is a risk of being injured that is inherent in all sports activities, including dance. Some of these injuries include, but are not limited to, the risk of fractures, paralysis, or death.

Medical Attention Acknowlegment

In case of physical injury or medical emergency, I hereby authorize Ms. Marianne Power of Performing Arts Inc. to make necessary arrangements to transport myself or my child to a medical treatment facility, as necessary. All such transportation and medical treatment will be at my sole cost and expense. In extreme emergency, or if my child is under 18 years of age, I understand that Ms. Marianne Power of Performing Arts Inc. will attempt to notify the person(s) I have named below as my emergency contact(s) of my condition and how to reach me.

Photo Release

Ms. Marianne Power of Performing Arts Inc. reserves the right to use photographs and videos taken during classes, workshops, performances, or other affiliated events for the purposes of instruction, advertising and promoting Ms. Marianne Power of Performing Arts Inc. and its programs. Students, or parents of students who are minors, who do not wish to comply with this policy must notify Ms. Marianne Power of Performing Arts Inc. prior to participation in class.

In signing this Release, I acknowledge and represent that I have fully informed myself of the content of the waiver and hold harmless agreement by reading it before I sign it, and I understand that I sign this document as my own free act and deed; no oral representations, statements, or inducements, apart from the written statement, have been made.

I further state that I am at least eighteen (18) years of age and am fully competent to sign this agreement; and that I execute this release for full, adequate, and complete consideration fully intending to be bound by the same.

I further state that there are no health-related reasons or problems which preclude or restrict my or my child’s participation in this activity, and that I will pay any medical costs that may be attendant because of injury to me or my child.

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.
Signature

Clear
Date

Auditions July 7th, July 14th, July 24th, July 31st