Holidays Collide Registration + No-Cost Application 2021
Sign in to Google to save your progress. Learn more
Parent Name (If over 18 - skip)
Dancer Name *
Age of Dancer *
Email *
Address *
City *
State *
Zip *
Where do you currently take dance classes? *
We need one helper from your family at some point, when it works in your schedule. Either at a rehearsal, behind the scenes or at a concert. Choices of activities and dates will be given this summer. 3-5 hour commitment total. *
We need one helper from your family at some point, when it works in your schedule. Either at a rehearsal, behind the scenes or at a concert. 3-5 hour commitment total. *
Required
Auditions are by VIDEO - any performance or class video works well. Many do NOT need to submit a video as we have recent video your child dancing from the past year. Dancers 8 and under do not need to submit a video and will be cast by age.
Clear selection
What styles will you be auditing for? *
How did you hear about Hollidays Collide? *
Costuming -Do you have a dance costume(s) that you can donate? We are looking for sizes 5t to adult, in our color scheme of red, black, silver, white and gray. High-quality monster Halloween costumes are also happy excepted. *
Required
Rehearsal Schedule - Please check all the dates that you will be able to attend rehearsal (each dancer will be allowed one absence) We don't have the concert dates set as we are waiting for theaters to schedule. If you cannot make the date after it's set let us know. Please note there will be ONE performance weekend. We have listed our top choices below. Weekends of Nov 12-14 OR Nov 19-21. *
Required
What time do your Saturday dance classes/other commitments end? *
Would you like to receive the Madison Community Dance Monthly Newsletter? *
Would you like to receive the occasional MCD Community Outreach Newsletter? *
Emergency Contact - Name and Phone Number *
Scholarship Application Section
Annual Household Income? *
Number of people living in your household? *
Is there an amount you can afford to put towards the concert? *
Please explain why you would like a scholarship *
PHOTO and VIDEO RELEASE Signature *
I give permission to use photographs and videos taken at the Madison Contemporary Dance Summer Intensive for advertisement materials, and the MCD website. Model Release for Minors: For good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, I hereby grant to: (the MCD “Photographer and Videographer”), her heirs and legal representatives the irrevocable and unrestricted right and permission to copyright, in her own name or otherwise, and use, re-use, publish and re-publish photographic portraits or pictures of me or in which I may be included, in whole or in part, as part of a composite or distorted in character or form, without restriction as to changes or alterations, in conjunction with my own or a fictitious name, or reproductions thereof in color or otherwise, made through any medium at her studios or elsewhere, and in any and all media now or hereafter known for illustration, promotion, art, editorial, advertising, trade, publishing, or any other purpose whatsoever (except pornographic or defamatory). I also consent to the use of any printed matter in connection therewith. I hereby waive any right that I may have to inspect or approve the finished product or products and the advertising copy or other matter that may be used in connection therewith or the use to which it may be applied. I hereby release, discharge, and agree to save harmless the Photographer, her heirs, legal representatives and assigns, and all persons acting under her permission or authority or those for whom she is acting from any liability by virtue of any blurring, distortion, alteration, optical illusion, or use in composite form, whether intentional or otherwise that may occur or be produced in the taking of such photographic portraits or pictures or in any subsequent processing thereof, as well as any publication thereof, including without limitation any claims for libel or invasion of privacy. I have read the above authorization, release, and agreement, prior to its execution, and I am fully familiar with the contents thereof. This release shall be binding upon me and my heirs, legal representatives, and assigns. I represent that I am the [parent/guardian] of the above-named model. For value received, I hereby consent to the foregoing on his/her behalf.
RELEASE OF LIABILITY FOR MINOR PARTICIPANTS Signature *
IN CONSIDERATION OF my child/ward named above being allowed to participate in any way in Madison Contemporary Dance and performances (“Releasee”) related events and activities, the undersigned acknowledges, appreciates, and agrees that: The risks of injury and illness (ex: communicable diseases such as MRSA, influenza, and COVID-19) to my child from the activities involved in these programs are significant, including the potential for permanent disability and death, and while particular rules, equipment, and personal discipline may reduce these risks, the risks of serious injury and illness do exist; and, FOR MYSELF, SPOUSE, AND CHILD, I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, even if arising from the negligence of the releasees, or otherwise, and assume full responsibility for my child’s participation; and, I willingly agree to comply with the program’s stated and customary terms and conditions for participation. If I observe any unusual significant concern in my child’s readiness for participation and/or in the program itself, I will remove my child from the participation and bring such attention of the nearest official immediately; and, myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY RELEASE AND HOLD HARMLESS Madison Contemporary Dance and A Step Above Dance and Music Academy its directors, officers, officials, agents, employees, volunteers, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the participation WITH RESPECT TO ANY AND ALL INJURY, ILLNESS, DISABILITY, DEATH, or loss or damage to person or property incident to my child’s involvement or participation in these programs, arising from the negligence of the releasees or otherwise, to the fullest extent permitted by law. I, for myself, my spouse, my child, and on behalf of my/our heirs, assigns, personal representatives and next of kin, HEREBY INDEMNIFY AND HOLD HARMLESS all the above Releasees from any and all liabilities incident to my involvement or participation in these programs, EVEN IF ARISING FROM THEIR NEGLIGENCE to the fullest extent permitted by law. I, FOR MYSELF, MY SPOUSE, AND FAMILY, HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, FULLY UNDERSTAND ITS TERMS, BY SIGNING IT AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT. This is to certify that I, as parent/guardian, with legal responsibility for this participant, have read and explained the provisions in this waiver/release to my child/ward including the risks of presence and participation and his/her personal responsibilities for adhering to the rules and regulations for protection against communicable diseases. I for myself, my spouse, and child/ward do consent and agree to his/her release provided above for all the Releasees and myself, my spouse, and child/ward do release and agree to indemnify and hold harmless the Releasees for any and all liabilities incident to my minor child’s/ward’s presence or participation in these activities as provided above, even if it arises from their negligence to the fullest extent provided by law. I have read, understood, and agree to all of the statements above. The re-entry of my name below will constitute a legal signature.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Mcvdance.com. Report Abuse