Broadway Sacramento Conservatory Application 2024 Application Participants InformationYour Name(Required) First Last Nickname First Grade Level in School(Required) Age(Required) Date of Birth(Required)Month123456789101112Day12345678910111213141516171819202122232425262728293031Year2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Gender Identity/Preferred Pronouns Please list any medical conditions, chronic ailments, allergic reactions, disabilities or school IEP accommodations that we should be aware of:T-Shirt Size(Required)Youth SmallYouth MediumYouth LargeUnisex SmallUnisex MediumUnisex LargeUnisex X-LargeOtherIf you chose 'Other' for T-Shirt size, Please let us know your desired size. Parent/Guardian Contact Information if participant is 18 years old or under.Is the participant under the age of 18 years old?(Required) Yes No Name (Parent/Guardian 1)(Required) First Last Relationship to Participant(Required) Your Address (Parent/Guardian 1)(Required) Street Address Address Line 2 City ZIP Code Mobile Phone (Parent/Guardian 1)(Required)Email (Parent/Guardian 1)(Required) Is this person allowed to pick up/drop off the child?(Required) Yes No Name (Parent/Guardian 2) First Last Relationship to Participant Your Address (Parent/Guardian 2) Street Address Address Line 2 City ZIP Code Mobile Phone (Parent/Guardian 2)Email (Parent/Guardian 2) Is this person allowed to pick up/drop off the child? Yes No Emergency InformationEmergency Contact(Required) First Last Relationship to Participant(Required) Emergency Contact Mobile Phone(Required)Will the participant be driving themselves?(Required) Yes No StatementParticipants of the Broadway Sacramento Conservatory must have at least two years prior training or performance experience. Please enter a statement describing the applicants prior training or performance experience in theatre, acting, voice, music, or dance.(Required)We are seeking to build a class of dedicated students. Please have the applicant write a statement explaining why they want to receive musical theatre training at the Broadway Sacramento Conservatory, and how it will help them reach their future goals.(Required)ScholarshipsA limited number of scholarships are available for Broadway Sacramento Conservatory applicants. I would like to apply for a Broadway Sacramento Conservatory Scholarship STATEMENT: Please provide a brief statement from a parent or guardian defining the circumstances of the scholarship application request and why their child would benefit from the experience of attending the Broadway Sacramento Conservatory.(Required)ReleasesRelease of Liability(Required) I am aware that classes at Broadway Sacramento involve active activities, and I am voluntarily permitting my child to participate in these activities. I hereby agree to accept any and all risks of injury to my child/myself that may result therefrom. I agree that I will not make a claim against or sue Broadway Sacramento or any of its principals, employees, volunteers or agents for injury or damage resulting from the use of the facility or other acts. I hereby acknowledge and agree to release, indemnify, and hold harmless Broadway Sacramento, its principals, employees and agents, and to assume full responsibility for any loss or damage on account of injury to my childMedical Emergency Release(Required) In case of accident or an emergency, I hereby give my permission to the staff of Broadway Sacramento to authorize any emergency medical care that may be required during my child’s participation in classes and workshops. I authorize Broadway Sacramento to take my child to the nearest emergency hospital for emergency treatment and measures that are deemed necessary for the safety and protection of my child. I understand that Broadway Sacramento does not carry or maintain medical insurance coverage for any participant. I agree to take responsibility for full payment of any emergency medical costs related to my child’s participation regardless of whether I have insurance coverage. Broadway Sacramento staff can only administer limited first aid assistance (bandaids).Authorization to Reproduce Physical Likeness(Required) I expressly grant to Broadway Sacramento and to its employees and agents the right to photograph, film, or videotape my child and to use the resulting images in media promoting Broadway Sacramento and its activities. I further grant the right to record and reproduce my child’s voice and all instrumental, musical, and other sound effects produced by my child. I hereby certify and represent that I have read the foregoing and fully understand the meaning and effect thereof.How did you hear about the Broadway Sacramento Conservatory program?Email from Broadway SacramentoBroadway Sacramento websiteFriend/Word of MouthSocial Media (Facebook, Instagram, etc.)OtherHave you or your child participated in a Broadway Sacramento education program in the past? Camp Music Circus Broadway At Music Circus Teens Broadway At Music Circus Kids Junior Company Broadway on Tour Workshops Musical Theatre Summer Intensives Summer Dance Class Series Broadway Sacramento Conservatory – Fall Session Internship or Professional Assistant Program Broadway Sacramento reserves the right to exercise discretion in accepting applicants. Enrollment is on a first-come, first-served basis and will end when we reach program capacity.CAPTCHA
