2024 Circus Smirkus Trouper Homestay Host Application
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Email *
Show Site *
You may choose more than one. The dates reflect the pick up date through drop off date.
Required
How many adults over the age of 18, including yourself, will be present in your household while you host Smirkus troupers? *
For each one of those adults over 18, including yourself, please provide: *full legal names* *full birth dates* and *email address.*
We use this information to conduct background checks of adults in the home to ensure the safety and security of our young performers, thanks so much for your detailed information.
Full Legal Name of Host Parent 1 *
Full Birthdate of Host Parent 1 *
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Email Address 1 *
Legal Name of Host Parent 2 (if applicable)
Full Birthdate of Host Parent 2 (if applicable)
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Email Address 2
Please tell us about the other members of your household.
Use this space to include FULL NAME and FULL BIRTHDATE and EMAIL ADDRESS of anyone over 18 years of age in your home. *If there are none, simply enter N/A.*
Names, Emails, Birthdates of other adults in household: *
(simply type N/A if not applicable)
Permanent Physical Address: *
*Please include Street, City, County, State, Zip*
Secondary Address
(Address of rental proporty; to be used for families who will be renting a home to host troupers)
Primary Phone *
Secondary Phone
Can you provide supervision for the troupers during the entire time they are away from Smirkus staff? *
 If not, please explain how you plan to manage the time you will be away.  
Is your schedule flexible enough to accommodate the troupers’ transportation* schedule? If not, how do you plan to get the troupers to and from the show site (carpool, etc.)? *
*A licensed adult (21 years of age or older) must drive the troupers’ back and forth to site; troupers are NOT allowed to drive themselves.  
Describe the accommodations you can provide for the troupers. Will they have their own rooms? Own beds? Share a bathroom?   *
Are there smokers in your home? *
Do you have pets? If yes, please tell us about them. *
(Including caged animals e.g. snakes or hamsters).
What is the distance in miles from your home to the show site? How long does it take you to drive to the site?   *
Ideal number of troupers you'd like to house? *
*minimum of 2
Maximum number of troupers you can house? *
Do you have preferences as to the ages and genders of the troupers who may stay at your home? *
If so, please indicate. We will do our best to accommodate your preference but if we are unable, would you still consider hosting?
Have you hosted Circus Smirkus troupers in the past? *
You may also use this space to let us know if there are specific troupers you would like to house this summer. We cannot always guarantee requests, but do our best to honor them whenever possible.
Some of our troupers have special dietary needs that as a homestay provider, you would be asked to accommodate. With advanced notice are you willing to host a trouper that may be vegetarian, vegan, lactose intolerant, or gluten-free? *
Please select which diets you CAN accommodate for.
Required
Why are you interested in hosting Smirkus troupers in your home? How did you hear about our homestay program? *
Please list the name, email, phone number, and relationship to you of two personal references. *
 (ie: principal or director of your child’s school, members of your community or religious group, co-worker, etc.)
I have received *and read* the Smirkus Homestay Handbook *
(if you have not received the handbook, email homestays@smirkus.org)
A copy of your responses will be emailed to the address you provided.
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