Stage 2: Junior Broadway Program Application
This is a juried application - not all applicants will be selected.

All students must APPLY if they wish to participate in the program. Successful candidates will be selected based on previous training and experience in the areas of singing, dancing and acting.

Please be aware that by submitting this form you are not guaranteed a spot in the program. All final decisions will be made by our Program Director.

Applications for the 2017/2018 season are due on Friday, June 16th, 2017. All successful applicants will be contacted about a spot in the program by Friday, June 23rd. Once all spots have been filled, a wait list will be created in order of
suitability for the program.

Child's First Name
Your answer
Child's Last Name
Your answer
Gender
Child's Date of Birth
MM
/
DD
/
YYYY
Grade Entering in September 2017
School Name
Your answer
Experience and Training in VOCAL MUSIC
Your answer
Experience and Training in ACTING
Your answer
Experience and Training in DANCE
Your answer
Additional Show Experience and Information
Your answer
T-Shirt Size for Production Shirt
Medical Information and Allergies
Your answer
Parent First Name
Your answer
Parent Last Name
Your answer
Parent Phone Number
Your answer
Primary Email Address
Your answer
Second Parent Email Address (Optional)
Your answer
Street Address
Your answer
City
Your answer
Emergency Contact Name
Your answer
Emergency Contact Phone Number
Your answer
Family Doctor's Name
Your answer
I hereby release Theatre Ancaster from all claims for damages arising from any accident or injury which is caused or arises from participation of the applicant during any program. Permission is hereby granted to Theatre Ancaster and its representatives to transport my child to a local doctor or hospital for medical treatment if necessary.
I give permission for Theatre Ancaster to use photographs and video of my child for publicity purposes.
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