Community Theatre Form - Frank Phillips College

Audition & Release Form

Name*
First Last
Age*
Address*
Street Address City State / Province / Region ZIP / Postal Code
Phone*
Email*
Briefly Describe your Theater Experience*
Click Here if you will accept any part offered:*
- Yes
- No
Even if you checked the box above, say here which parts especially interest you, & which parts you will not accept:*
Are you willing to alter your appearance for this production?*
- Yes
- No
Would you participate in any of the below areas for this production?
Check all that apply.
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Participation Release:*
I authorize that Borger Community Theatre, and those acting pursuant to its authority, to (1) record my participation and appearance on videotapes, audiotape, film, photograph or any other medium; (2) Use my name, likeness, voice and/or biographical material in connection thereto; and (3) exhibit or distribute such material in whole or in part without restrictions or limitations for any publicity or promotional purpose which Borger Community Theatre, and those acting pursuant to its authority, deem appropriate.
- I accept
Signature*
Type Signature Here Date

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