Membership Form - Fond du Lac Community Theatre

Name *

Are you under 18 years old? *I am 18 years of age or olderI am under 18 years oldIf the member is under 18 years of age, the remainder of this form should be completed by their parent or guardian.

Parent/guardian submitting this form *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Email Address *

Phone *

Involvement: Please check any areas you are interested in helping with for future FDLCT seasons.PerformingCreative (props, costumes, sets, hair/makeup)Stage manager/crewMusician/Conductor/AccompanistChoreographing/dance captainLights/Sound/TechDirecting or assistant directingVolunteering (box office, ushers, etc.)Publicity (advertising, fundraising, design, or photography))Event planning/special programsFacilities/building maintenanceServing on Board of Directors/governance

Optional: Would you like to receive the FDLCT newsletter?

Yes, please send me the monthly email newsletter!

Advertising/Photo Release *

Advertising is key to the success of FDLCT. I, therefore, give permission for photos or video to be taken of me during FDLCT sponsored events (workshops, rehearsals, performances, volunteering, etc.) to be used by FDLCT for publicity, with the understanding that it will only be used to illustrate and promote FDLCT via social media, newspaper, and any other sanctioned FDLCT advertisement technique. All photos or video captured are the property of FDLCT.

Harassment Policy *

I have read and am fully aware of FDLCT's Harassment Policy.

Contract *

I have fully read and understand the guidelines/rules of the Actor Contract (actors) or Honorarium Contract (paid production team members).

Code of Ethics *

I have read and agree to the FDLCT Code of Ethics.

Waiver *

I, the undersigned, forever release, discharge and waive the Fond du Lac Community Theatre and its staff, officers, directors, agents and volunteers from any and all liability rising from, related to, or connected with any injury, illness, or damage for any reason caused by or sustained in the course of any participation in classes, performances, rehearsals, or any other activities conducted by or associated with the Fond du Lac Community Theatre.

I hereby attest that this waiver of liability is provided voluntarily upon submission of this form and shall be fully binding upon me, my heirs, next of kin, executor, administrator and/or personal representative.

E-Signature *

I agree to sign this agreement electronically by typing my full name below. I understand that I may instead ask for a paper form if I do not wish to sign electronically.

E-Signature *Please type your full name as your e-signature.