Please submit a headshot/selfie. Does not need to be professional, just so we know what you look like for reference

I understand that there is a participation fee of $75. This is to help cover cost costume, supplies, etc.

List dates and any notes.

I give CCCMT permission to photograph, film, or record my child in rehearsal, performance and/or production. I understand that CCCMT may use these images for publicity, advertising, or for applications for grant funding. I give full permission and agree to waive all copyright and future considerations.

I declare that I am the parent/responsible party of the above named actor. In the event my actor is injured or should require medical attention, I hereby request that you contact me or our emergency contact. In the event that we cannot be reached, I hereby authorize CCCMT to secure necessary medical treatment for actor. I further acknowledge that I will be responsible for any medical or hospital fees or costs associated with my actors medical treatment or hospital fees or costs associated with.

I assume all risks and hazards from participation in this production and hereby waive, release, absolve and indemnify and agree to hold harmless CCCMT , it’s organizers, sponsors, directors, volunteers, and participants for any claim arising out of injury to my actor. My signature below indicates that I have read, understand, and agree to the terms.