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2021 Youth Ensemble Audition Registration Form
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Dancer's Name
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Parent/Guardian's Name
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Address
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Phone number - parent(s)/guardian(s)
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Dancer's Age (as of Sept 1, 2021)
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Dancer's Grade (as of Sept 1, 2021)
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Dancer's Height (in feet and inches - please try to give us an accurate measurement, which is important for casting and costuming purposes!)
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Name of Dance Studio(s)
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Name of School
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Years of tap training?
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Other dance styles? (please list)
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Special skills? (singing, aerial work, tumbling, etc.)
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Experience dancing in high heeled shoes?
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Rehearsal will be held on Sundays from 3:00-5:00pm beginning after Labor Day and running through THE TAPCRACKER the weekend of December 10-12. Do you have any known conflicts with this time slot?
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Dancers cast in lead roles (Clara, Mouse Queen, Tapcracker) or cast in advanced pieces with our adult company dancers may be asked to stay late on occasional Sundays for rehearsal. Would your dancer be available to stay until 7 or 8pm on select dates with advanced notice?
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Does your child have any injuries, medical conditions, or special needs of which we should be aware? If yes, please explain.
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Please upload your dancer's headshot - JPG preferred
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How did you hear about our Youth Ensemble? (check all that apply)
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By completing this form, you will be added to our monthly e-newsletter list. Please check here if you do NOT wish to be added to our list.
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RELEASE FROM LIABILITY, WAIVER OF CLAIMS, AND ASSUMPTION OF RISK
Please initial each statement below. For dancers under 18, this form should be completed by a parent or guardian.
By signing this Release Waiver and Assumption of Risk, (herein referred to as the “Release”) I agree that The Lady Hoofers Tap Ensemble (TLHTE) shall not be responsible for any and all injuries and causes of action which I, or my child, may sustain while training, practicing, performing, or during any event or activity either on or off premises. All participants should consult with a physician before engaging in such activities.
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I understand that dance has inherent risks of injury, which can aggravate a pre-existing physical condition or cause new injuries. These risks include, but are not limited to, muscle pains and strains, broken bones, fractures, or any other personal injury to any part of the body. I recognize that I am exposing myself to such risk when undertaking dance activities. I understand that these risks cannot be fully eliminated without jeopardizing these essential qualities of the activity. I assume and accept all risks of injury and damages resulting from such dance activities. My participation in this activity is purely voluntary, and I elect to participate, in spite of the risks.
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I further understand that I have been advised of the need for me to be covered by adequate insurance to cover any injury or damage that may be suffered while participating, and I have obtained such accident and/or health insurance or have agreed to bear the costs of any such injury or damage myself.
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In case of physical injury or medical emergency, I hereby authorize The Lady Hoofers Tap Ensemble to make necessary arrangements to transport me to a medical treatment facility as necessary. All such transportation and medical treatment will be at my sole cost and expense. I understand that The Lady Hoofers Tap Ensemble will attempt to notify the person(s) I have named below as my emergency contact(s) of my condition.
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I also agree that the Ensemble is not responsible for any property loss or damage suffered by me, or any guest or family member of mine that result upon entry into my presence or in the presence of the Ensemble or its surrounding property.
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I understand that photographs and video may be taken for archival and promotional purposes. I give my permission for the public display of any photos, video, or audio recording of myself for advertising, news coverage, or use in any other media source associated with The Lady Hoofers Tap Ensemble.
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SIGNATURE
Type your full name to serve as your digital signature
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Date
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Emergency Contact Name
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Emergency Contact Relationship to Dancer
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Emergency Contact Phone Number
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