2012 Theatre Camp Audition Form FCT - Fauquier Community Theatre

July 16-27, 2012, 10a-230p
Performance 7pm on Friday, July 27
All campers must be available all camp days including the performance.
Audition Form
Student’s Name: ________________________________ Birthdate:__________
Age: ____________ School: ________________________Grade: __________
Parents Names: _______________________________ Moblie: ________________
Email: ______________________________________ Home Phone: ___________
Address: ____________________________________________________________
Does your child have any food or medicine allergies Describe______________________________________
Is your child currently taking any medications Please list __________________________________________
Emergency Contact:_______________________________ Phone: _____________
Relation to child: _________________________________
How did you hear about FCT’s Musical Theatre Camp _______________________
Voice Type (circle one): HIGH LOW NOT SURE
Height: _________________
Please list any previous theatrical experience, dance lessons, choirs, music lessons,
and/ or special talents here:
Auditioning for (Circle all that apply):
Mr. Warbucks Grace Miss Hannigan Rooster & Lily Orphans Annie
Director’s notes (please leave blank):

July 16-27, 2012, 10a-230p
Performance 7pm on Friday, July 27
All campers must be available all camp days including the performance.
Release, Waiver of Liability, and Indemnity Agreement
I hereby agree with Fauquier Community Theatre (FCT) to the following, by affixing my
signature below on this date. In connection with my and my child’s participation in the Musical
Theatre Summer Camp program (“Program”), I understand and acknowledge the nature and
extent of the activities that will be involved in the Program and assume the risk inherent in such
activities on behalf of myself and any minor children. I voluntarily waive any and all claims,
costs, liabilities, expenses (including attorney’s fees), and judgments against FCT, their
directors, officers, employees, servants, subcontractors and agents, and hereby release, excuse
and discharge FCT, their directors, officers, employees, servants, subcontractors and agents from
all claims, costs, liabilities, expenses (including attorney’s fees), and judgments which may arise
out of my or my child’s participation in the Program and all aspects attendant thereto. The
undersigned further agrees to indemnify and hold FCT their directors, officers, employees,
servants, subcontractors and agents harmless from any and all claims, costs, liabilities, expenses
(including attorney’s fees), and judgments which may arise out of my or my child’s participation
in the Program.
I am the parent or legal guardian of :
__________________________________________________________ Name of Minor Child
I am signing this agreement on behalf of said minor and acknowledge that in so doing, I am
giving up legal rights and remedies that I, my spouse, a legal guardian for the minor, or the
minor might have now or in the future.
_____________________________________________________________________________
_ Signature of Parent/Guardian Print Name of Parent/Guardian Date