Broadway Camp – Production Application Posted 2021-03-20 by Jessica Sims Student Name* First Last Gender Identity: Male Female Non-Binary Personal Pronouns: He/Him She/Her They/Them Adult T-Shirt Size*SMLXLXXLDate of Birth*MonthMonth123456789101112DayDay12345678910111213141516171819202122232425262728293031YearYear202720262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Grade Level This Fall*9th10th11th12thGraduate this JuneSchool*School District*High School Drama Teacher(s)*Theatre InterestsWhat other areas of production and technical theatre interests you? (Set, Lights, Sound, Costumes, Props, Stage Management, Directing, Marketing, Social Media or Other?)First Choice*Second Choice*What other areas of production/technical theatre interest you? (Check all that apply.) Costumes Sets Lights Props Sound Stage Management Directing Other (Marketing, Public Relations, Social Media, etc.) Production/Technical ExperienceIf you have a resumé, please attach below. If not, please list previous production and technical experience. PLEASE NOTE all production students will be on the running crew for the production.Upload Resumé Here (optional):Max. file size: 20 MB. Upload Headshot Here (optional):Max. file size: 20 MB. School photos are perfectly acceptable!If no resumé, please list previous production and technical experience.Please list the title of the show, position in the crew, and your grade/location at the time.Have you taken any special training in production/technical theatre? Yes No If yes, Where? When? Length? (Workshop, Semester, School Year)Have you taken any master class or workshops at Collaborative School of the Arts? Yes No If yes, which ones?Performance Experience(i.e., school, community theatre, Church/Temple, professional experience, etc.)Do you have any performance experience? Yes No If yes, please list show role & location.Other talents?i.e. accents, gymnastics, musical instruments, juggling, etc?MarketingHow did you hear about Broadway Camp? (Please check all that apply) Social Media Web E-mail Playbill Flyer Word of Mouth Other: (please list) Other (please list):Primary ResidenceGuardian's Name* First Last Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Guardian Email* Guardian PhoneStudent Email* Student Phone*Consent*I, (the parent/legal guardian of the child above) hereby give and forever grant Proctors Collaborative permission and consent for value received and without further consideration or compensation to the use (full or in part) of photos and all videotapes taken, recordings made of the child’s voice and/or written extraction, in whole or in part, of such recordings or musical performance for the purposes of illustration, broadcast, web cast or distribution in any manner by Proctors Collaborative for Collaborative School of the Arts or for any other purpose. It is the intent of Proctors Collaborative to use these photographs and videos in educational materials and future promotions of the theatre. I further warrant to Proctors that I am the parent or legal guardian of the above-stated child and have every right to grant the permission outlined above: I agree to the aboveGuardian Signature* First Last Date* MM slash DD slash YYYY
