Nutcracker Audition Form 2016

Dancer's Full Name *

First Name Last Name

Dancer's Age by Sept. 1st, 2017 *

Parent/Guardian's Email *

Dancer's Email (if they would like to receive communications)

Parent/Guardian's Full Name *

First Name Last Name

Parent/Guardian's Cell Phone Number *

- Area Code Phone Number

Parent/Guardian's Home Phone Number *

- Area Code Phone Number

Parent/Guardian's Address *

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Emergency Contact Name *

Emergency Contact Phone Number *

- Area Code Phone Number

List all genres of dance studied, along with number of years studied *

Past Nutcracker parts with ages danced and year danced. *

Dancer Height *

Dancer Weight *

Dancer's Hip measurement in inches *

Dancer's Waist measurement in inches *

Dancer's Chest measurement in inches *

Dancer's LEOTARD size *

Company Casting *

Headshots (Only in .zip or .jpeg format) *

Home Studio *

Pointe experience *

Yes No

If Yes, how many years en pointe *

Dancer T-Shirt Size *

Child S Child M Child L Child XL Adult S Adult M Adult L Adult XL

Name of Insurance Company *

Insurance Policy Number *

I am not covered at this time

No Insurance

List any allergies or medical conditions, including current injuries: *

Release and Waiver of Liability and Indemnity Agreement: Physical activities such as dance carry a risk of injury to participants. I hereby release the Civic Ballet of Volusia County of any liability whatsoever arising out of an injury, damage or loss which may be sustained by said person during the course of involvement with the Nutcracker. This includes activities held in the studio, in theaters during performances or rehearsals, and during any other dance performance or rehearsal sponsored by the CBVC. I have read this waiver agreement, understand its contents, and accept and assume such risks. *

I Agree

Student Media Waiver: By submitting this registration below, we give our consent to the CBVC to use the student’s name, photograph, likeness, and all work in order to promote the CBVC. We understand that the student may be called upon by journalists to answer questions about his/her involvement in the Nutcracker, and we will also allow the student to speak to any media via phone or television. *

I Agree

I agree to make SUNDAY NUTCRACKER rehearsals a priority, including the MANDATORY SUNDAY of THANKSGIVING WEEKEND, and that I will pay the $100 production fee required *

I Agree

I understand that dropping from the production once casting is completed may result in ineligibility the following year, pending circumstances *

I Understand

I understand that there is a 15 hour minimum family volunteer requirement that all CBVC families must fulfill, or can be bought out for $10 per volunteer hour *

I Understand

I understand that there is a miss policy of one excused absence due to illness, family emergency or pre-approved special circumstance. A second absence may result in dismissal from the Nutcracker production, with parts reassigned to understudies *

I Understand

Once submitted you will receive an email to the email address provided, confirming your entry. If you have not received an email please check your junk / spam box as sometimes they filter directly there. *

I Understand

CBVC Audition Fee *

CBVC Audition Fee $ 20.00

CBVC Nutcracker Audition Registration 2017