Please enable JavaScript in your browser to complete this form.Participant InformationImportant Note: Participant's contact information will be used only in relation to the production by the production staff. Phone/ text messages will be made at appropriate hours. Name *FirstLast Preferred PronounExample: He/Him, She/Her, They/Them (you are not obligated to disclose) Age as of April 1, 2024 *Parent / Guardian Name *FirstLastEmail *Phone *Text Message: Can we communicate with you via text message?YesNoAddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeDo you have adequate transportation? *Yes NoCan we provide any additional accessibility accommodations for your proposal interview? Participants are not obligated to disclose any health or physical conditions. The Selma Arts Center will provide accommodations to the best of our abilities. Production ProposalTitle of proposed small project Do song or play rights need to be obtained for your small project? Who owns the rights? (exp. MTI, Concord Theatrical, Broadway Licensing)Is this an original piece?YesNoWhat is the audience rating of your proposed project? GPGPG-13RProject Synopsis: Please give a brief description of your project. If a play, or original work, please give a summery of the plot, characters, actor age ranges, historical significance, explanation of audience rating (G, PG, PG-13), and an explanation of how you believe it fits with the ethos of Selma Arts Center. You will be asked to present this information to the Selma Arts Council if selected for an interview. Specific needs for your small project: Please tell us your requirements or the supplies you would need to produce your small project. For example: size of stage space, craft supplies, use of sound system or lighting system, classroom space, audience space, rehearsal space. You will be asked to bring visuals during your interview process. Design concept if applicable to a performance piece: Please explain your vision for set design, Costume concept, lighting/ projection specialties, dance level (minimal, mild, difficult), etc. Feel free to upload a pdf of example images or sketches of your design concepts below. (copy)You will be asked to bring visuals during your interview process. Upload a visual of your concept. Click or drag a file to this area to upload. Production Crew: Please include a production crew list of members and designers you plan on bringing on board with you for the project. If you are in need of production staff, the Selma Arts Center has regular members, as well as applications, on retainer and can connect you a production crew if needed. (Production Crew includes Stage manager, Choreographer, Music Director, Costumer, Set/Lighting/Sound Design, etc.) Budget: Please refer to the Proposal Packet to list the level of your budget. You will be asked to submit a more detailed budget during your interview. A workable budget will pre-approved line items will be provided. Small Project ($0-$200 budget)Medium Project ($200-$500) budget)Please email nicolettea@cityofselma.com for a workable budget with pre-approved line items. Experience Please list your experience to support your small projectEducation- Degree Level, Major or Grade LevelDo you have technical theater expeiance? Yes SomeNoPlease include technical training in the theater experience section or resume. List your experience or education relevant to your small project, including workshops:List the qualities that define you as a leader: If this is your first time leading a small project, what personal qualities do you have that would help you succeed: Would you be able to help supply your own volunteers to help with your project?List your most recent experience below (or upload a resume):Upload your résumé Click or drag a file to this area to upload. If you have an arts related resume, please upload here or email to nicolettea@cityofselma.comWould you like to be notified of future SAC related opportunities? *Yes, I would like to be notified No, I would not like to be notified By submitting "yes" your information will be saved in our actor/volunteer database. Participation Waivers (You will be required to sign a hard copy during your audition check in) As a condition to my participation in the above program conducted or sponsored by the City of Selma/ Selma Arts Council, I understand and agree to the following: That the City/ Arts Council, its officers, employees, and agents shall not be liable for any loss, damage, injury or liability of any kind to any person caused or arising from acts, omissions or negligence of the City/ Arts Council, its officers, employees or agents relating to or arising from my participation in the above program. That I will defend, indemnify and hold harmless the City of Selma/ Selma Arts Council and its officers, employees and agents from and against any and all loss, liability, charges and expenses (including attorney’s fees) and causes of action of whatsoever character which may arise by reason of participation in the above program or in any way connected therewith. The City of Selma/ Selma Arts Council does not provide accident, medical, liability or any other insurance for program participants. I also understand my picture might be taken as part of the program (or video submission) to promote our program on flyers, brochures, City website and marketing pamphlets. **Those convicted of a felony or registered as a sex offender will not be permitted to participate or volunteer for the Selma Arts Center** By Signing I verify that I have read and understand this condition to audition/volunteer. Signature *Clear SignatureParent / Guardian Signature *Clear SignatureAssumption of the Risk and Waiver of Liability Relating to Covid-19 I agree that the City of Selma, its officers and employees and agents shall not be liable for any exposure to or infection with Coronavirus and/or COVID 19, or any other contagious or infectious disease arising out of my child’s participation in in the above program and that I will defend and indemnity the City of Selma, its officers, employees or agents from and against any loss, liability , charges and expenses (including attorneys fees) arising out of my child’s exposure to or contraction of any disease arising from participation in the above program. I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to my child(ren) or myself including but not limited to, personal injury, disability, illness, damage, loss, claim, liability, death or expense of any kind that I or my child(ren) may experience or incur in connection with my child(ren)’s attendance at the above program. On my behalf and on the behalf of my child(ren)’s, I hereby release, covenant not to sue, discharge, and hold harmless the City of Selma’s employees, agents, and representatives, of and from any claims, including liabilities, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any claims based on the actions, omissions, or negligence of the City of Selma, it’s employees, agents, and representatives, whether Coronavirus and/or COVID-19, or any other infectious disease occurs before, during or after participation in any of the City of Selma’s Community services program or by participating in activities held on the City of Selma’s property. Signature *Clear SignatureParent / Guardian Signature *Clear SignatureSubmit
