WBI Summer Theater Intensive for High School Students
This is an 8-week summer program for high school students in which they will create and perform an original work of theater centered around the topic of immigration in America. The group will use creative and performing arts to explore the issue and generate content to engage community in dialogue and social change action.

Registration Fee: $25
Once registration fee is secured you will be contacted to schedule an audition which will entail:
~a reading of a monologue (options will be provided by WBI at the audition)
~a presentation of a prepared piece selected by student (monologue, song, dance, music, poem etc.)
~an interview

Program Timeline:
Registration Deadline: This form must be submitted by Wednesday, May 1st 2019
Audition Week: May 13th-17th
Notifications: Week of May 20th
Program Begins: Monday, June 24th

General Information:
Program will run Monday-Thursday from 10:00 am - 3:00 pm
Anticipated show dates are Thurs Aug 15th, Fri Aug 16th, and Sat Aug 17th 2019.

Tuition: $600
Tuition comes due once accepted in the program.
Payment plans can be made, and financial aid is available for qualified students.

Questions & More Information contact Artistic Director Kolton Harris, at kharris.writersblock@gmail.com
or call 860-442-5625

Applicant's Name *
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Applicant's Address (including street, town, zip) *
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Applicant's Email *
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Applicant's Phone (optional)
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Applicant's Birthdate & Age (must be 13-17 or currently enrolled in High School) *
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Applicant's School Name & Town
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Grade (entering)
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What are the applicant's creative interests? (can choose more than one) *
Required
Applicant: Please tell us why you are interested in participating in this program. *
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Parent/Guardian's Name *
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Parent/Guardian's Address (including street, town, zip code (if same as applicant, just write "same") *
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Parent/Guardian's Email Address *
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Parent/Guardian's Phone Number(s) *
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Relationship to Applicant *
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Emergency Contact's Name *
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Emergency Contact's Phone Number(s) *
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Emergency Contact's Relationship to Applicant *
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Waiver of Liability Statement: I agree to indemnify and hold Writer’s Block InK, its program, staff, agents, representatives, employees and or any person or place that holds classes, auditions, rehearsals or performances related to activities for these entities harmless for any damages incurred now, or during the term of this agreement, from any injury of any kind resulting from my child/ward’s participation in these programs and activities. I understand that in case of illness, injury, accident, or any other damage to my child/ward's person or property while participating in these programs which may require attention by a physician and/or hospitalization, I will bear the expense personally or by insurance that I have provided. Any other cost or damages resulting from my child/ward's participation in these programs, such as the cost of transportation by an emergency vehicle or damages to third persons, is also to be paid by me or by my own insurance. *
I affirm that this application may be electronically signed. I understand that the electronic signature appearing on this application is the same as handwritten signature for the purposes of validity, enforce-ability and admissibility. Name of Parent/Guardian for Electronic Signature: *
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