Get documents about "Performer's Application _fill in form_ - ACT - San Diego
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- 12/29/2012
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PLEASE BRING COMPLETED APPLICATION WITH YOU TO AUDITIONS/CALLBACKS.
ALL PORTIONS OF THE APPLICATION MUST BE COMPLETED AND TURNED IN AT THE SAME TIME.
ANY UNCOMPLETED APPLICATION MAY HOLD UP YOUR AUDITION.
This cover sheet is your checklist. Do NOT turn in with application.
Please complete this checklist to verify that you have completed the entire application:
□ Page 1 Audition Application
□ Page 2 Contact Information / Performer’s Fee
□ Page 3 Potential Conflicts
□ Page 4 Behavior Contract
□ Page 5 Medical Release, Photo Release
□ Page 6 Waiver/Release of Liability
□ Headshot attached
□ $275 Production Fee
Please check and verify signatures are on the following pages
□ Pages 2, 3, 4, 5, 6 Participant’s signature & Parent’s signature of minors
AUDITION #
AUDITION FORM
Show auditioning for: THE WIZARD OF OZ – YOUNG PERFORMER’S EDITION
Participant’s Name:
Last First M
School You Attend: Grade:
Height: Birth Date: Age: Female Male
How did you hear about us:
Vocal Range:
Read Music: Yes No Play Instrument: Yes No What instrument:
Affiliations (Check any that apply): AEA SAG AFTRA AASD
Special Skills we should know about:
List previous theatrical / singing / dancing experience (or attach a resume). Include a headshot with your application.
PLEASE DO NOT WRITE BELOW THIS LINE
Director’s Notes:
pg. 1 (R-12/8//12)
PARTICIPANT
Name:
Address:
Number & Street City Zip
Home Phone: ( )- Cell Phone: ( )-
Work Phone: ( )- E-Mail:
PARENT/GUARDIAN: If participant is under 18 years of age, please fill out the following information:
Mother / Guardian Name:
Address:
Number & Street City Zip
Home Phone: ( )- Cell Phone: ( )-
Work Phone: ( )- E-Mail: ( )-
Father / Guardian Name:
Address:
Number & Street City Zip
Home Phone: ( )- Cell Phone: ( )-
Work Phone: ( )- E-Mail:
PERFORMER’S FEE
Production fee of $275.00 is due at auditions.
Please DO NOT AUDITION if you will not accept whichever role the director deems appropriate for you. Full refund will be
made only if you are NOT offered a role. If you are offered a role and you notify us within 24 hours after the cast list has
been sent out that you are not accepting, you will be given a partial refund of $200.00 of the production fee.
If you notify us after the 24 hour period is up, no refund will be given.
There are no exceptions to this policy.
There is a $35.00 charge for checks returned for non-sufficient funds.
Please be aware conflicts are not accepted during tech and/or performance weeks. See conflict page for more information.
Participant’s Signature: Date:
Parent/Guardian Signature of Minor: Date:
Check #: Amount: $ Date:
Visa / MC / Discover #: Security Code:
Expiration Date:
pg. 2 (R-12/8//12)
CONFLICTS
This production requires your complete commitment. It is very difficult to cast a show and then run rehearsals when we
have performers missing. When you are called to rehearsal it means we need you. Please understand your conflicts can
affect your casting. Once you have been cast in a role, no conflicts beyond those listed below will be approved.
Absolutely no conflicts will be accepted during tech and/or performance weeks.
Rehearsal Schedule is subject to change.
DIRECTIONS: Please review the rehearsal schedule and list any potential conflicts you might have. Mark your conflicts
below. An "X" indicates that you are not available at all on that rehearsal day. If you are only available for a window of time on a
particular day, please indicate the hours that you ARE available. Leave the space blank if you are available to rehearse that day.
• Not all rehearsals require the entire cast every night; some nights for specific characters and other times the whole
company.
PERFORMER’S NAME________________________
Day Date Time
Tue 1/8/2013 4-6pm Auditions
Wed 1/9/2013 4-6pm Callbacks
Thu 1/10/2013 4-6pm Callbacks
Mon 1/14/2013 4:30-6:30pm
Wed 1/16/2013 5:30-7:30pm
Mon 1/21/2013 4:30-6:30pm
Wed 1/23/2013 5:30-7:30pm
Mon 1/28/2013 4:30-6:30pm
Wed 1/30/2013 5:30-7:30pm
Mon 2/4/2013 4:30-6:30pm
Wed 2/6/2013 5:30-7:30pm
Mon 2/11/2013 4:30-6:30pm
Wed 2/13/2013 5:30-7:30pm
Mon 2/18/2013 4:30-6:30pm
Wed 2/20/2013 5:30-7:30pm *(Location TBD)
Mon 2/25/2013 4:30-6:30pm
Wed 2/27/2013 5:30-7:30pm
Sun 3/3/2013 12-4pm Load-in
Mon 3/4/2013 4-8pm Tech Rehearsal No conflicts allowed
Tue 3/5/2013 4-8pm Tech Rehearsal No conflicts allowed
Wed 3/6/2013 4-8pm Tech Rehearsal No conflicts allowed
Thu 3/7/2013 4-8pm Tech Rehearsal *(Location TBD) No conflicts allowed
Fri 3/8/2013 Performance: 7pm No conflicts allowed
Sat 3/9/2013 Performances: 2 & 4pm No conflicts allowed
Sun 3/10/2013 Performance: 2pm & Load Out No conflicts allowed
Participant’s Signature: Date:
Parent/Guardian Signature of Minor: Date:
pg. 3 (R-12/8//12)
BEHAVIOR CONTRACT
Our goal is to provide an educational theatrical experience for all. This requires a respectful, encouraging, and supportive environment
from all who are involved. Inappropriate, rude, or disrespectful behavior will not be tolerated and is grounds for dismissal.
ATTENDANCE GUIDELINES:
I agree to arrive at scheduled rehearsals on time and in appropriate clothing and shoes.
PARENTS: I realize that if my minor child is chosen for the cast, I am responsible to make sure he/she attends
every performance and every rehearsal for which he/she is scheduled. In case of illness, I will notify the Stage
Manager in advance.
I agree to attend all rehearsals for which I am scheduled. I understand that it is extremely important that every
participant be at rehearsal when called. For the good of the show and out of respect for the actors and staff, the
director must know my part is covered. Attendance is taken at each rehearsal. Unexcused absences may result in
having my role in the production reduced, or in the case of extended absence, I may be dismissed from the
production without a refund.
I understand that arriving more than thirty minutes late, or leaving more than thirty minutes early, from a rehearsal
constitutes an absence.
I understand that I was asked to list ALL conflicts on my conflict sheet BEFORE my audition. If I am not present at
any rehearsals during a time NOT on my conflict sheet, it will be considered an unexcused absence.
If I miss a choreography rehearsal or if I have arrived too late (as determined by the choreographer), I am
responsible to connect with the choreographer or dance captain to cover any missed material. If too much
material has been missed, I understand that I may forfeit participation in that dance number, regardless of the
excuse and regardless of prior notice.
I will remain at rehearsals until the rehearsal is completed and I am excused. I understand that for my safety, if I
am under age 18, I am not allowed to leave the rehearsal/theater premises without adult permission and
supervision UNLESS PARENT/LEGAL GUARDIAN AUTHORIZATION AND WAIVER/RELEASE OF LIABILITY
has been signed.
I understand that work is not an excuse to miss a rehearsal.
BEHAVIOR GUIDELINES:
I will be respectful and courteous to the directors, the cast, band and crew members, and the volunteers.
I will maintain a positive and cooperative attitude, and support and encourage my fellow performers. I will listen
while others are being rehearsed or coached.
I will be prepared for rehearsals with my script, music, a pencil, and water.
I will have my lines and music memorized on due dates. I will practice outside of rehearsal.
I understand that no food or drink, except water, is allowed on the dance/rehearsal floor or stage. There will be a
designated place to eat snacks/meals.
I will help clean up the rehearsal/performance hall and dressing rooms after rehearsal and performances.
I know that if the Director thinks I am not fulfilling my obligations, he/she will have a conference with me that could result in
my removal from the show at any time. If this does happen, I understand his/her decision is final and no fees will be
refunded. If I am under 18 my parents will be notified.
ACT - San Diego is not responsible for and assumes no liability for any loss, damage, or theft of anyone’s personal
property. Every person assumes full responsibility for their personal property.
I HAVE READ AND UNDERSTAND THE CONDITIONS LISTED ABOVE AND AGREE TO ABIDE BY THEM.
Participant’s Signature: Date:
Parent/Guardian Signature of Minor: Date:
pg. 4 (R-12/8//12)
MEDICAL RELEASE
If you or your child in involved in an ACT – San Diego production, you are hereby advised that our organization does not carry Workers
Compensation Insurance for participants or volunteers. If you or your child should suffer an injury while participating in our production,
you will be personally responsible for your medical or injury related expenses.
I give permission for my child(ren)
to participate in an ACT – San Diego production. I also give permission to the designated adult supervisor in charge to secure
emergency medical treatment for the minor named above. I also agree to hold harmless from any liability, fault or action arising from
participation in the production and waive any claim or action against ACT – San Diego, and/or their assignees, board of directors, staff
or volunteers.
Participant’s Signature: Date:
Parent/Guardian Signature of Minor: Date:
Participant’s Name:
Last First MI
Birth Date: Age:
Adult in charge may give my child Tylenol: Yes No Adult in charge may give my child Advil: Yes No
Are there any health conditions, medications or allergies that we need to know about?
Insurance Provider:
Insurance Policy #: Phone:
Doctor: Phone:
Dentist: Phone:
List two contacts other than mother/father/guardian:
Emergency Contact Name & Phone #:
Emergency Contact Name & Phone #:
If under 18 years of age, following information is required:
Mother/Guardian Name:
Address:
Number & Street City Zip
Home #: Cell #: Work #:
Father/Guardian Name:
Address:
Number & Street City Zip
Home #: Cell #: Work #:
PHOTO RELEASE
I hearby authorize and consent that ACT – San Diego shall have the absolute right to copyright, publish, use, sell or assign
any and all photographs, portraits or pictures, television spots, movie films, videotapes and/or sound recordings, or any part
thereof, that have been taken of my child, or in which my child may be included in whole or in part without notice or
compensation to me, now or in the future.
Participant’s Signature: Date:
Parent/Guardian Signature of Minor: Date:
pg. 5 (R-12/8//12)
WAIVER/RELEASE OF LIABILITY
I hereby voluntarily release ACT – San Diego from any and all liability resulting from any and all acts, occurrences or incidents arising
out of myself and/or minor child participating in said activity.
I understand and agree that I am releasing not only the entities set forth above, but also the officers, agents, and employees of those
entities. I understand and agree that this Waiver/Release will have the effect of releasing, discharging, waiving, and forever
relinquishing any and all actions or causes of action that I or my minor child may have or have had, whether past, present or future,
whether known or unknown, and whether anticipated or unanticipated by me or my minor child, arising out of myself or my minor child
participating in said activity.
I understand and agree that by signing this Release of Waiver/Release of Liability, I am assuming full responsibility for any and all risk
of death or personal injury or property damage suffered by me and/or my minor child participating in said activity.
I understand and agree that by signing this Waiver/Release of Liability, I am agreeing to release, indemnify, and hold harmless ACT -
San Diego and their officers, agents, and employees from any and all liability or costs, including attorney fees, associated with or
arising from myself and/or minor child from participating in said activity.
I understand that this Waiver/Release of Liability will be binding on me, my spouse, my heirs, my personal representatives, my assigns,
my children, and any guardian ad litem for said children.
I understand and agree that by signing this Waiver/Release of Liability I am obligated to pay for any and all damages to any property of
the RELEASED PARTIES caused negligently, willfully or otherwise by myself and/or minor child.
I acknowledge that I have read this Waiver/Release of Liability and that I understand the words and language in it. I also understand
that Waiver/Release of Liability is valid for the duration of time that myself and/or my minor child participates with ACT – San Diego
unless rescinded through my written instructions.
IF PARTICIPANT IS UNDER THE AGE OF 18:
I am the parent or legal guardian of the minor
and I am signing this Waiver/Release of Liability on behalf of said minor. I have read and understand this agreement and realize it
relates to releasing valuable legal rights and does so freely and voluntarily.
Print Minor Child’s name: Age:
Print Name of Parent/Guardian:
Signature of Parent /Guardian: Date:
Telephone Number (best number to reach you):
IF PARTICIPANT IS 18 YEARS OF AGE OR OLDER:
Print Participant’s Name: Age:
Signature of Participant: Date:
Telephone Number (best number to reach you):
pg. 6 (R-12/8//12)
