Choreographic Fellowship Application - Vitacca Productions & Company
Choreographic Fellowship Application

Choreographic Fellowship Application

   Registration Form:   
Date

Participant

First Name Last Name
DOB

Contact Information

Address Line 1
Address Line 2
City State Zip
Phone Cell Email

Experience

Please list your professional / pre-professional experience
Please list your dance training experience
Tell us about yourself or provide an artistic biography
What are your future artistic aspirations
If selected for the Choreographic Fellowship Program, you may be given the opportunity to present your work within a future event. Please tell us about your proposed piece.
(DVD and/or YouTube links of your work samples are strongly encouraged)

Miscellaneous

How did you hear about Vitacca Productions & Company / Vitacca Dance Project?
(Please check all that apply)



References

Reference #1
Name Title
Phone EMail
Reference #2
Name Title
Phone EMail
Reference #3
Name Title
Phone EMail

Release

In consideration for receiving permission to participate in this audition, or any and all activities related thereto, including but not limited to travel between sites or locations (“Activities”), I hereby release, indemnify, and covenant not to sue Kelly Ann Vitacca, Vitacca Productions and Company, and any officers, principals, agents, associates or employees thereof (“Releasees”), for any and all claims, costs and causes of action for property damage or personal injury, sustained by me while participating in Activities, whether arising from statute, code, ordinance, tort, common law or other source. I acknowledge that Activities I will perform may be physically strenuous. I know of no physical or mental condition which would preclude or inhibit my full participation in Activities. I am fully aware of the risks and hazards involved with Activities, and I choose to voluntarily participate.

I Agree
Name of Participant, Parent or Guardian Date
 

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