BERGEN PAC NUTCRACKER AUDITION | NJ School of Ballet

Bergen PAC NUTCRACKER - Registration Form

Student's Name

Parent/Guardian's Name

Street Address

City / State / Zip Code

Phone Number

Date of Birth

Grade In School

Years of Ballet

Years of Pointe

Current Dance Studio

Optional Message:

Audition for:

Angels 9/30 @ 3:30PM

Clowns 9/30 @ 5:00PM

Assumption of Risk, Liability Waiver and Indemnification: I understand and agree that participation in any class, lesson, workshop, rehearsal, performance or other activity conducted by New Jersey Ballet Company, Inc. or NJ School of Ballet, LLC (together, New Jersey Ballet) poses the possibility of injury, loss, damage or death. I agree, therefore, to assume, all risks and responsibility for any such injury, loss, damage or death which might occur to me (or my child) by reason of any New Jersey Ballet class, lesson, workshop, rehearsal, performance or other activity. I also agree to waive, release and discharge New Jersey Ballet, its members, officers, directors, agents, volunteers, assistants, employees, guest artists and faculty members from any and all losses, damages, liability, claims, demands or causes of action of any kind that may arise out of my (or my child’s) participation in any classes, lessons, workshops, rehearsals, performances or other activities conducted by New Jersey Ballet. I further agree to indemnify and hold harmless New Jersey Ballet, its members, officers, directors, agents, volunteers, assistants, employees, guest artists and faculty members from any and all losses, damages, liability, claims, demands or causes of action of any kind, including reasonable attorneys’ fees, that may arise out of my (or my child’s) participation in any New Jersey Ballet class, lesson, workshop, rehearsal, performance or other activity. If I am signing this assumption of risk, liability waiver and indemnification on behalf of my child, I represent that I am authorized to do so and acknowledge that my child shall be bound by the assumption of risk, liability waiver and indemnification provisions contained herein. The assumption of risk, liability waiver and indemnification provisions contained herein shall also apply to my (or my child’s) heirs, successors and assigns.

Signature

I agree to the terms & conditions

Select an item ($)

Audition Fee - $20

Established 1953

Bergen PAC NUTCRACKER - Registration Form

Email: Info@njballet.org

Tel: 973-597-9600

Fax: 973-377-2528

7-9 Vreeland Road, Florham Park, NJ 07932