Draft Online Reg Form | Connecticut Ballet

Nutcracker 2023
Audition and Registration Form

Child's First Name

Parent/Guardian #1

Parent/Guardian #1 Email

Parent/Guardian #1 Cell #

Child's Last Name

Parent/Guardian #2

Parent/Guardian #2 Email

Parent/Guardian #2 Cell #

In case of emergency, contact persons (in call order):

Contact #1

Contact #2

Contact #3

Relationship to child

Street Address

City

State

Zip code

COVID-19 vaccination status:

Vaccinated

Unvaccinated

Date of Birth

Previous dance training (School, # of years, ballet levels)

Previous experience in Connecticut Ballet productions, if any

Other performance experience:

Height (inches)

Any serious allergies** and/or recent injuries?

Yes

Leotard/shirt size

If yes, please specify

**Cast members with serious allergies may be required to be accompanied by a parent/guardian

Any siblings also auditioning?

Yes

Sibling Name(s)

Sibling Age(s)

List any major date conflicts you are aware of between Oct & Dec 2023

Additional HARTFORD PERFORMANCE OPPORTUNITY

Most children's cast members will be required to attend rehearsals at The Bushnell on Thursday, December 20 (afternoon/early evening) plus performance dates (Friday, December 21 and Saturday, December 22).

If asked, my child(ren) would be available to participate in the December 20-22 Hartford performances.

_____ Yes _____ No

Connecticut Ballet will determine who is assigned as backstage chaperones and/or boutique volunteer staff at a later date and will then confirm your participation.

I, ____________________________ parent of ___________________________ do hereby release from liability Connecticut Ballet, Inc., for all injuries sustained during the course of this audition or subsequent rehearsal, class or performances, on the physical premise of Connecticut Ballet Center, or any rehearsal or performance venue during this production (October 2023-January 2024). Transportation to and from rehearsal and performances is the responsibility of the parent of each cast member. Connecticut Ballet shall have the right to use the name, photograph, video or other likeness of any cast member at any time throughout this production period and at any future time.

Special Waiver: I hereby acknowledge that Connecticut Ballet has taken all necessary steps to abide by local and state health advisories and protocols to protect against the threat of Covid-19 while conducting its business operations, including but not limited to social distancing for parents/performers/staff, availability of hand sanitizer, disinfection of high-touch areas, modifications to space usage, reinforcing signage, mask-wearing requirements, etc. I understand the risks associated with exposure to Covid-19 in the larger community. Therefore, I hereby waive any liability on the part of Connecticut Ballet and hold it and its employees harmless in the event that I, my child, or members of my immediate family unit were to contract the Covid-19 virus during the upcoming NUTCRACKER production.

I agree to the terms & conditions listed above and hereby affix my signature which is legally binding.

Parent/Guardian Signature

Date

Before submitting, please upload:

one headshot
one full body shot (from head to toe) in dance attire with dancer in 1st position

Dancer head shot:

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Full body shot in 1st position

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Nutcracker 2023 Audition and Registration Form

Nutcracker 2023
Audition and Registration Form