Participant's First Name * Participant's last name * Participant's email address (you will receive a confirmation email here, so please check this address). * Participant's Date of Birth (DD/MM/YYYY) * Contact Information
Participant's Cell Phone * Participant's Tshirt Size
Participant's home mailing address * Participant's city * Participant's state * Participant's zip * Participant's country
Is the participant male, female, non-binary?
Home Phone of Participant * Participant's current year in school (or what grade they are entering in the fall if it is summer)
Name of Participant's current school * Emergency Contact Full Name (Please do not list a parent who lives in the same home as the participant.) * Emergency contact's relationship to the participant * Emergency Contact home mailing address * Emergency Contact Email address Emergency Contact Cell Phone Number * Parent/Guardian First Name * Parent/Guardian Last Name * Parent/Guardian Mailing Address (or write same as participant). * #1 parent/guardian's place of employment * #2 parent/guardian's place of employment Parent/Guardian City Parent/Guardian State Parent/Guardian Zip Code Parent/Guardian Cell Phone * Parent/Guardian Email Address * How did you hear about Lovewell? Please be as specific as possible. * NEW STUDENTS ONLY: Did a Lovewell Alumni OR Lovewell staff member recommend Lovewell to you? If yes, please state their full name here. Do you have health issues or special needs of which we should be aware? HOW DO YOU LIKE TO BE CREATIVE AND COLLABORATIVE?
Lovewell is about collaboration, the desire to be part of the creative process from the ground up, and finding your own authentic voice through whatever art form suits you. It is a place to bring all of your wildest ideas and biggest dreams. It is a place where every idea spurs another thought that may become the basis of an entire show. Please answer the mandatory questions below to the best of your abilities. There is no right or wrong answer, there is only "what you think" and that is what we want to hear.
Have you been part of a Lovewell workshop in the past? Please list the shows that you helped to create. What interests you most about the collaborative, creative process? * Please be specific about what you would like to contribute to this workshop. Are you a writer? Composer? Designer? Singer? Dancer? Circus Clown? Builder? Seeker of new skills and experiences? Or any other creative person under the moon? * Please share something creative that you were a part of in which you are very proud. (Links to online material i.e. YouTube, Vimeo, etc. welcome or email material to firstname.lastname@example.org and let us know you did so in the text box here.) Don't be shy! *
RELEASE STATEMENTS FOR APPLICANTS 18 AND OVER. THOSE UNDER 18 MUST HAVE PARENTAL CONSENT.
1. Acceptance. I understand that my attendance will be confirmed only upon the acceptance of this application.
2. Health. I certify that I am in normal health. Prior to the start of the workshop I will notify Lovewell of any unique medical considerations.
3. Behavior. I understand that I am subject to the ordinary discipline requirements of attending a youth workshop and that failure to comply with reasonable behavioral requirements will result in dismissal from the workshop without refund.
4. Publicity. I agree that I may be photographed, or video taped, or both, and give consent for Lovewell to use these photos, tapes, or DVD’s to promote future Lovewell Institute programs and workshops, or for such other uses as Lovewell may reasonably see fit.
I certify that I have read and agreed to the Release Statements
TERMS OF COPYRIGHT OWNERSHIP
All copyrights from this workshop and performance will be held by Lovewell Institute. Please review our Terms of Copyright Ownership.
This statement describes the terms for your participation in the Lovewell Workshop.
Lovewell instructors will participate with you and help you write, perform and produce a piece of musical theater and video (the “Work”). The work will be a joint creation of the Lovewell instructors, you, and the other participants, based on ideas, characters and stories from the participants’ imaginations and experiences.
Lovewell will give you attribution (public credit) for your contributions to the Work in the playbill produced for the performance at the end of the Workshop. Lovewell will attempt to require any third party that purchases or licenses any rights to the Work do the same.
Lovewell retains all right, title and interest, including copyrights, in the Work, and you assign and transfer your contributions in the Work to Lovewell. Also, Lovewell has the right to use your name, likeness, voice and biographical information in order to promote or publicize Lovewell, the Workshop and the Work.
Please note that you assign and transfer any contributions to the Workshop that you may have created entirely on your own. Therefore you should only bring material to the Workshop that you are willing to share and transfer to Lovewell.
I hereby acknowledge my acceptance of the above Release Statements and Terms of Copyright Ownership.
I have read the Terms of Copyright Ownership and I hereby acknowledge my acceptance of them. I hereby acknowledge my acceptance of the terms of partnership
I agree to all terms above. * I am the parent/legal guardian of this participant.