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 between the hours of 8am and 9pm only. Emergency phone calls pertaining to the production are the only exception. Auditionees can choose to be notified of future Selma Arts Center opportunities by selecting the option below. Name *FirstLast Preferred PronounsExample: He/Him, She/Her, They/Them (you are not obligated to disclose) Age as of March 31, 2023 *Parent / Guardian *FirstLastEmail *Phone *Text Message: If cast, can production communicate with you via text message?YesNoAddressAddress Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeWould 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. Can we provide any additional accessibility accommodations Participants are not obligated to disclose any health or physical conditions. The Selma Arts Center will provide accommodations to the best of our abilities. Can you read music? (If applicable) YesNoIf applicable, please list relevant dance experience.You have the option to submit a resume below. 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