Children’s Auditions

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Date Submitted

MM slash DD slash YYYY

Performer

Performer's Name*

Herein referred to as The Performer

First Last

Age*

Please enter a number from 6 to 16.

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Parent/Guardian Name*

Herein referred to as "Guardian"

First Last

Phone 1*

Phone 2

Email*

Experience

Mark all that apply

Please indicate whether your child has experience in any/all of the following areas:

Acting

Ballet

Hip Hop

Singing

Jazz

Lyrical/Contemporary

Please list any past productions your child has participated in, and their role in each:

Emergency Information

*NO medications will be administered or distributed by ITM staff. We have first aid supplies available if needed.

Please list all specific medical conditions including any allergies (food, drug, etc.), disabilities, or emotional / behavior issues that you feel we should be aware of:

Medical Conditions

Does the dancer carry any medications with them?*

Yes

List All Medications:*

In an emergency, who should we contact other than parent/guardian?*

Emergency Contact Phone Number*

Note: Insurance is the responsibility of the parent/student.

Consent and Agreements

Photo Release*

As Guardian, Oyo Dance Company and Inspiration to Movement have my permission to use The Performer's likeness in a photograph, video, or other media in any and all of its publications, including web based publications, without payment or other consideration.

I agree to the Photo Release policy.

Today: 02/21/2025
IP Address: 18.226.133.136

Medical Release*

I, Guardian certify that The Performer is in good health and may participate in the activities at Inspiration to Movement (ITM). In case of an emergency requiring medical treatment, the undersigned hereby authorizes ITM to get the student to any medical or hospital facility for care and treatment and accept any payment responsibility for any treatments. This release is effective for the period one year from the date given below.

I agree to the Medical Release policy.

Today: 02/21/2025
IP Address: 18.226.133.136

Liability Release

I, Guardian, give my consent for The Performer to participate in programs at ITM and I am aware that dance training and the athletic exercises associated with it place unusual stress on the body and carry the risk of physical injury that include but are not limited to muscle strains and tears, broken bones, or even death. On behalf of my child and myself (and if I am no longer a minor, on my own behalf), I assume the risk and in consideration of the benefits derived from ITM, I waive all rights, causes of actions, release an claims from the student while participating in said activity or while in the act of being transported to and from said activity including any and all consequential damage claims which I may be entitled to recover from said injury or property damage claim without regard to negligence of the parties, and I do hereby agree to indemnify and hold harmless, release and discharge the building owners, and/or ITM, staff, assistants, agents, representatives, instructors, directors and/or owners. It is understood that this agreement is binding on myself, my heirs, executors, administrators and assigns. I understand that good dance training involves touching and adjustment of the student’s body by the instructor.

I agree to the Liability Policy.

Today: 02/21/2025
IP Address: 18.226.133.136

Name

This field is for validation purposes and should be left unchanged.

Fairy Tales

Actors and Dancers
Ages 6 – 18

Performance Dates

Questions? Email president@oyodancecompany.org or call 614-253-6683

Children's Audition Application

Performer

Experience

Emergency Information

*NO medications will be administered or distributed by ITM staff. We have first aid supplies available if needed.

Consent and Agreements

Fairy Tales

Actors and Dancers Ages 6 – 18

Performance Dates

Questions? Email president@oyodancecompany.org or call 614-253-6683

Children's Audition Application

Performer

Experience

Emergency Information

*NO medications will be administered or distributed by ITM staff. We have first aid supplies available if needed.

Consent and Agreements

Actors and Dancers
Ages 6 – 18