Student Thespian Festival Registration Packet

STUDENT THESPIAN FESTIVAL REGISTRATION PACKET DUE ______NAME: ______

1. ______Complete Health Care Consent and Code of Conduct Forms Must be signed by both you and your parents

2. ______$_____ cash or check made out to SCHOOL NAME

3. ______T-SHIRT SIZE (circle one) S M L XL 2XL 3XL 4XL

4. ______Food Needs (circle all that apply) Gluten-Free Vegetarian *Banquet Meal only includes a vegetarian and non-vegetarian option, salad available for gluten-free needs. Please plan accordingly. 5. ______Optional events selected—details in additional packet Improv Team (limited to eight students)

Theatre Tech Challenge Team (limited to six students)

Devised Theatre (One to two per school)

Nebraska Thespian Scholarship (SENIORS ONLY)

College Auditions (JUNIORS & SENIORS ONLY)

Individual Event (May only select ONE category) ____ Monologue PERFORMANCE PIECE DETAILS: ____ Duet Acting Play/Musical: ______Group Acting Author: ______Solo Musical Theatre Publisher: ______Duet Musical Theatre ____ Group Musical Theatre ____ Lighting Design TECH PRESENTATION DETAILS: ____ Scenic Design Play: ______Sound Design Author: ______

____ Stage Management Project Description: ______Costume Construction ______Costume Design ______Short Film ______Theatre Marketing ______STUDENT CODE OF CONDUCTObserving the following rules will make the State Festival a pleasurable experience for all in attendance.  I realize that attending the state thespian festival is a privilege and that I am expected to attend all scheduled festival activities.  I realize that as a participant of the festival, I may not be rude, uncooperative, or discourteous and I will be attentive, cooperative, and appropriate at all times.  I realize that I am representing not only my school and troupe, but also my school district.  I realize that the proper theatre response is applause with laughter (or tears) at appropriate moments, showing appreciation for all performers, presenters, and audience members.  I will respect all festival participants; hotel personnel, university staff, and I will treat all workshop leaders as professionals and with courtesy and respect.  I will not destroy, damage, take, or rearrange any property that does not belong to me.  I will pick up any trash. I will not bring any food or drinks inside meeting rooms or the theatre at the festival.  I will not use a cell phone or IPOD in any meeting room.  I will not take flash photography of any performance.  I realize that if I am late to an all-festival event, I must wait outside quietly until the ushers allow me to enter.  I realize that if I must leave during a performance, I must wait until an appropriate time to exit.  I will not leave the festival at any time without the approval of my Troupe Director.  I understand that consuming dugs, tobacco, or alcohol, or found to be under the influence of these substances at any time during the festival will mean that I will be sent home at my parents expense on the FIRST violation. This includes smoking and chewing.  I understand that proper attire (including shoes) must be worn at all times during the festival. I understand that I should wear comfortable clothes for workshop activities and dress appropriately for theatre attendance. I understand that I may not wear any gang apparel or hats in the theatre and that I may not wear any apparel with gang, sexual, drug and alcohol references at any time.  • I understand that I must wear my identification badge at all times and it is my admittance into all festival activities.  I realize that festival members who cannot follow the code of conduct will be sent home.  I agree to the code of conduct and will comply with all rules.

______Print Name of Delegate Signature of Delegate

______Print Name of Parent Guardian Signature of Parent Guardian

Consent, Acceptance and Health Form The Nebraska Chapter, an affiliate of the Educational Theatre Association, requires that this form be completed for each delegate (students and adults) attending the Nebraska State Thespian Festival at the UNL & Embassy Suites If a Delegate is a minor (under 18), a parent or legal guardian must complete this form. The health center will not treat adults. Medications will be charged to the delegate. If you substitute a delegate, you must supply a new completed health form. Type or print legibly. Enter name exactly as it appears on registration form. Return by November 20, 2017.

Delegate information

______Delegate’s first name (as on registration form) Last name Gender ______Thespian Troupe no. Name of School Delegate’s birthdate ______(______)______Home address (street, city, state, zip) Phone number ______(______)______Name of parent/guardian/next of kin Phone number ______Name of troupe director or chaperone attending Nebraska State Thespian Festival

I. RELEASE The undersigned hereby releases and agrees to indemnify, save and hold harmless the Nebraska State Thespian Festival, & The Nebraska Thespians, the International Thespian Society, the Educational Theatre Association, the University of Nebraska & The Embassy Suites, and all respective officers, employees, agents and representatives of the aforementioned entities ( each an “Organizer” and collectively the “Organizers”) from and against any and all claims, demands, causes of actions, losses, liabilities, judgments, damages, costs and expenses (including reasonable attorneys’ fees) resulting from the Delegate listed above participating in the Nebraska State Thespian Festival The undersigned shall give each Organizer prompt written notice of any claim or facts or circumstances that might give rise to any claim for indemnification. The undersigned further agrees to be responsible for Delegate while traveling to and from the Nebraska State Thespian Festival, including any expenses incurred by the Delegate, caused by the Delegate, and/or any personal injuries which may occur to the Delegate. The undersigned authorizes the Delegate to be released to the Troupe Director or Chaperone listed on this form.

II. RULES AND REGULATIONS The undersigned agrees that the Delegate shall abide by the Nebraska State Thespian Festival’s security rules and regulations (as described in detail at least at nebraskathespians.org). The undersigned understands that, if the Delegate violates any of the Nebraska State Thespian Festival’s security rules and regulations, the Delegate may be returned home, and the undersigned (or other parents and/or legal guardians) may be financially responsible for all necessary costs incurred while sending Delegate home. The undersigned also understands that the Nebraska State Thespian Festival’s registration fees cannot be refunded.

III. PHOTO/VIDEO RELEASE The undersigned irrevocably consents to being photographed or being recorded by means of video or audio tape recording by the Organizers, or a designated representative of the Organizers. These photographs and/or recordings can be used, without compensation to the undersigned and/or the Delegate, in any public display, publication or media, or website, or in any manner or form, and at any time by the Organizers in promotion of the mission to promote the theatrical arts and have theatre arts recognized in all phases of education. The undersigned releases the Organizers, and their employees, agents, representatives, associates, Board of Directors members, and consultants from any liability in connection with the use of such photographic, video, and/or audio materials.

IV. AUTHORIZATION I consent to the use or disclosure of protected health information by the Bryan Medical Center West for the purpose of analyzing, diagnosing, and providing treatment to the above stated delegate, obtaining payment for health care services rendered or to be rendered, or to conduct health care operations. A copy of this consent is as valid as the original. I authorize my insurance benefits to be paid directly to the Bryan Medical Center West I assume full responsibility for and agree to pay for all services rendered or to be rendered. I understand I have a right to receive a copy of this consent upon request, and to revoke this consent in writing at any time except to the extent that Bryan Medical Center West has taken action in reliance on this consent. This authorization is valid one year from the date signed or through the term of coverage of the policy, and during the required period to process the claims.

The Delegate or the Delegate’s parent and/or legal guardian has read, understands, and agrees to be bound by the above provisions, as evidenced by their signature below:

______Signature of Delegate’s parent and/or legal guardian Date

______Signature of Delegate Date