Nutcracker Registration

NUTCRACKER REGISTRATION FORM

Nutcracker Audition Registration

Date:

Name (as it would appear in the program):

Address:

Age:

Birthdate:

Grade in School:

Height:

Dance School you attend:

The professional company rehearses during the day from 10:45-4:15. If you are cast you may be called to a rehearsal with the company. What time can you rehearse after school on a normal school day:

List days off of school and early dismissal dates:

List any dates with known conflicts:

List all emails you would like information sent to:

List all phone numbers you would like to receive remind texts from:

Parent or Guardian #1

Parent or Guardian #1 phone number:

Parent of Guardian #2:

Parent or Guardian #2 phone number:

Name of other Emergency Contact:

Phone number for other emergency contact:

Signature of Dancer:

By checking, I confirm that I have read all of information and agree to fulfill commitments associated with participating in The Nutcracker.

Signature of Parent or Guardian:

By checking, I confirm that I have read all of information and agree to fulfill commitments associated with participating in The Nutcracker.

Signature of Parent or Guardian

I understand that all rehersals are mandatory for my child. Missing rehearsal may result in my child's role being canceled.

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613 17th Street - Rock Island, IL 61201 - (309) 786-3779 - [email protected]
Ballet Quad Cities School of Dance - 617 17th Street - Rock Island, IL 61201 - (309) 786-2677 - [email protected]