Brighton Beach Memoirs Audition Form

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Audition Form

Email *

Name

Email Address

Mobile Phone Number

Are you over 18 years of age

Yes

Clear selection

Which roles would you like to be considered for?

Will you accept a different role

Yes

Clear selection

Emergency Contact Name

Emergency Contact Relationship

Emergency Mobile Phone Number

Liability Release: Liability release: I agree to (or authorize my minor child to) audition for this production with Liability Release:I AGREE TO (OR AUTHORIZE MY MINOR CHILD TO) AUDITION FOR THIS PRODUCTION WITH THE GEORGETOWN PALACE THEATRE, WITH THE UNDERSTANDING THAT IF CAST, I (OR MY CHILD) WILL PARTICIPATE IN REHEARSALS AND PERFORM IN THE LIVE SHOW. I AUTHORIZE THE GEORGETOWN PALACE THEATRE (OR ANY OF ITS DIRECTORS OR OFFICERS) TO USE AT THEIR SOLE DISCRETION, ANY IMAGE, PHOTOGRAPH, FILM OR VIDEO OF ME (OR MY CHILD IF PERFORMER IS A MINOR) FOR PUBLICITY OR ARCHIVAL PURPOSES NOW OR IN THE FUTURE. I ALSO UNDERSTAND THAT LIVE PERFORMING ARTS ACTIVITIES HAVE POTENTIAL RISKS AND WITH MY SUBMISSION OF THIS FORM RELEASE THE GEORGETOWN PALACE THEATRE FROM ANY FAULT OR LIABILITY, AND AGREE TO HOLD THE GEORGETOWN PALACE THEATRE HARMLESS IN ANY MATTER THAT MAY ARISE OUT OF MY VOLUNTARY PARTICIPATION IN THIS PROJECT. Please indicate your acceptance by checking the box.

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