REGISTER - Repertory Ensemble Auditions
1) Please review REPERTORY ENSEMBLE DOCUMENT PACKET:
https://tinyurl.com/RepEnsemble-doc-packet-2018

2) Complete all information below to register.

3) Click SUBMIT when you are done. (All questions must be answered for form to properly submit.)

AUDITION DETAILS:
Friday, May 18
Location: Motion 41 Dance
5:30-6:30 - JUNIORS (Age 8-12)
6:30-7:30 - SENIORS (Age 13+)

PLEASE NOTE: By auditioning for a place in the junior or senior level Repertory Ensemble, you are agreeing to the information contained in the REPERTORY ENSEMBLE DOCUMENT INFORMATION, including tuition and attendance requirements, and payment due dates to both American Midwest Ballet and Motion 41 Dance. The information contained in this document allows our Repertory Ensemble program to run smoothly and provide a positive experience for all.

REPERTORY ENSEMBLE DOCUMENT PACKET: I have read this packet in its entirety. I agree to abide by its contents on behalf of the minor I am registering, for whom I am parent or legal guardian. *
Required
STUDENT IS REGISTERING FOR *
Required
STUDENT'S FIRST NAME *
Your answer
STUDENT'S LAST NAME *
Your answer
STUDENT'S AGE ON May 18, 2018 *
Your answer
DATE OF BIRTH *
Please format as MM/DD/YYYY
Your answer
STUDENT IS *
PARENT'S FIRST NAME *
or Legal Guardian
Your answer
PARENT'S LAST NAME *
or Legal Guardian
Your answer
RELATIONSHIP TO STUDENT *
example: Mother, Father, Grandparent, etc.
Your answer
STREET ADDRESS *
Your answer
CITY *
Your answer
STATE *
Your answer
ZIP CODE *
Your answer
PRIMARY PHONE NUMBER *
Enter the main number at which we can easily contact a parent. Please format as XXX-XXX-XXXX.
Your answer
DOES PRIMARY PHONE NUMBER ACCEPT TEXTS? *
SECONDARY PHONE NUMBER *
Enter the best phone number to use if parent is unreachable at primary phone number. Please format as XXX-XXX-XXXX.
Your answer
DOES SECONDARY PHONE NUMBER ACCEPT TEXTS? *
PRIMARY EMAIL ADDRESS *
Audition results will be emailed to this address. This is American Midwest Ballet's primary form of communication with you.
Your answer
SECONDARY EMAIL ADDRESS
Leave blank if none. Do not re-enter your primary email.
Your answer
Please indicate if parent or guardian would like information about joining the ballet guild. *
The American Midwest Ballet Guild is an outstanding group of volunteers dedicated to supporting American Midwest Ballet through fundraising events such as merchandise boutiques and our annual Nutcracker Tea Party, while enjoying the company of other arts supporters. Children of guild members are invited to join the Junior Guild which hosts several special social, dance, and fundraising events throughout the year specifically for our youngest patrons.
Required
NAME OF DANCE STUDIO WHERE STUDENT WILL TAKE CLASSES 2018-19 *
*NOTE: Students from all dance studios throughout the community are welcome to audition
Your answer
NUMBER OF DANCE CLASSES STUDENT IS ENROLLED IN PER WEEK *
*NOTE: In addition to weekly Repertory Ensemble classes/rehearsals, ongoing additional classes are required at dance studio/s of your choice.
Your answer
NAME OF ACADEMIC SCHOOL STUDENT WILL ATTEND 2018-19 *
Your answer
STUDENT'S ACADEMIC GRADE LEVEL FOR 2018-19 SCHOOL YEAR: *
Your answer
PARTICIPATION AGREEMENT AND RELEASE OF LIABILITY: By checking the box below, I agree to the following on behalf of the minor I am registering, for whom I am the parent or legal guardian: *
THIS IS A LEGAL DOCUMENT WHICH INCLUDES A RELEASE OF LIABILITY. READ IT CAREFULLY. I understand and accept that my preparation for and participation in American Midwest Ballet’s Repertory Ensemble and/or Jr. Repertory Ensemble program (“the Program”) may expose me to physical risks. Some of the risks which may be present or may occur include, but are not limited to, physical injury or illness, death or disability. I hereby assume the above risks, which may be associated with my participation in or preparation for the Program. I also understand that my participation in or preparation for the Program may subject me to rigorous physical exertion. I hereby represent that I am in sufficient physical condition to accept a rigorous level of physical activity. If my health condition changes, such that at a later time I am not sure if I am in sufficient physical condition to accept the rigorous level of physical activity that the Program may require, I will so inform American Midwest Ballet (the “Company”). I accept responsibility for obtaining appropriate accident, health and hospitalization insurance to cover myself in the event of personal injury. I further understand and agree that the Company is not responsible for personal property that may be lost or stolen during my participation in the Program. I also give my consent to the Company and its affiliates to produce, reproduce and use, without charge, limitation or condition, photographs, film, footage, or other audio or video recordings or streaming programs that may include my image, persona or voice for purposes of promoting, marketing, displaying or interpreting the Company’s programs, services and/or productions worldwide. In consideration of the opportunity to participate in the Program, I do hereby covenant not to sue, and hereby release and agree to hold harmless, to the fullest extent permitted by applicable law, the company and all of its affiliates, officers, employees, directors, contractors, volunteers, dancers, representatives and agents from and against any and all liabilities, actions, damages, expenses, costs, causes of action, debts, claims and demands of every kind and nature whatsoever, which I now have or which may arise out of, or in connection with, my participation in or preparation for the Program. The terms hereof shall serve as a release, indemnification, and assumption of risk for myself and my heirs, executors, personal representatives, successors and administrators and for all members of my family, including any minors accompanying me. Prior to signing this document, I had an adequate opportunity to read and understand it, consult with counsel of my choosing to discuss its impact on me, ask questions of the Company about it, and my questions were answered to my satisfaction. I further agree that if any portion of this Release is held to be invalid, illegal or unenforceable then the remaining provisions of this Release shall still continue in full force and effect and remain binding upon me and my successors, heirs and personal representatives to the greatest extent allowed by applicable law.
Required
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