2020 TAKE IT FROM THE TOP at CITY OPERA HOUSE
Optional Scholarship application may be selected at the end of this form.
Email address *
Student First Name *
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Student Last Name *
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Age *
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Class Selection *
Address *
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City *
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Zip Code *
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Student email address *
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Phone *
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Primary Contact: Parent or Guardian name *
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Primary contact email address *
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Parent or Guardian # 2 Name and address
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Emergency contact name *
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Emergency contact phone *
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MEDICAL INFORMATION AND FOOD ALLERGIES List any medical conditions that may affect your child's participation, as well as any food allergies. If there are none, enter NONE. *
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One 'Take It From The Top' Tee shirt per student is included. Please select the correct size.
Assumption of risk and release of liability
Knowing that participation in the event entails some risks, and in consideration of my child being permitted to participate in the program:

1. I agree to release City Opera House (COH) and Take It From The Top (TIFTT) from any and all costs, claims, injury or illness resulting from my child’s participation in the program.

2. I agree that neither COH or TIFTT, nor any of its employees, independent contractors, directors and/or officers will be held liable for any injury which may occur to me or my child while attending the workshop. This includes, but is not limited to, any activities in which I/he/she may participate including classes in singing, dancing, physical comedy, stage craft, theatrical mask work, warm-up exercises and or breaks.

3. I grant COH or TIFTT permission to contact emergency services and permit treatment should I/my child become injured and I am unable to provide direct authorization for services.

4. I hereby release COH or TIFTT and their respective employees, independent contractors, director and/or officers from any and all/legal or financial claims.
I, parent or guardian of the applicant student, agree to the Assumption of Risk and Liability statement. *
Required
Media Release
Participants are sometimes photographed and videotaped for use in City Opera House (COH) and Take it From The Top (TIFTT) promotional and educational materials.

1. I authorize COH or TIFTT to record the image and voice of the subject named above and give COH, TIFTT and all persons or entities acting pursuant to COH or TIFTT permission or authority, all rights of use of these recorded images and voice.

2. I understand said images and/or voice will be used for education, advertising and promotional purposes in all conventional and electronic media. I also authorize the use of any printed material in connection therewith.

3. I understand and agree that these images and recordings may be duplicated, distributed with or without change, and/or alterations in any form or manner without future compensation or liability, in perpetuity.

4. I grant COH or TIFTT permission to take photographs, and/or make video or audio recordings of me/my child, and use them in connection with the promotion or publicity for COH or TIFTT.
I, parent or guardian of the applicant student, agree to the Media Release statement. *
Required
Full name of School *
Your answer
Grade *
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Experience *
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The application requires the student's headshot photo. Please send a .jpg or .pdf headshot to tiftt@cityoperahouse.org
Student sample video
Advanced Workshop applicants must submit a skills video. The video does not determine if a student should be in the Advanced Workshop. Parents or the student determines which workshop is better for them. The video helps the teaching artists get to know students’ skills before the Workshop begins. Broadway Intensive applicants are encouraged to submit a sample video, as well. If you need help recording a video, please contact tiftt@cityoperahouse.org to request audition dates and times.
Your answer
Need-based scholarships are available. Do you want to apply for a scholarship? *
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