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Broadway Gems Records presents:

Craig Schulman’s Broadway At Your School!
Musical Theatre Workshop & Benefit Concert Program

Online Application
(It is recommended that you print and/or save a copy of your completed application for your records.)

("*"indicates required field.)

*Child's Name:

*Child's Age: *Date of Birth (dd/mm/yyyy):

*Current Grade: Height:

*Sex (Check one) Male: Female:

*Current School: (BAYS! Program is open to all area residents.)

*Primary Parent/Guardian Name:

Address:

*Street Address:

*City:

*State:

*Postal Code (00000-0000):

*Date and Location of BAYS! Workshop Program:

*Daytime phone (include area code and extension, if any):

*Nighttime phone (include area code and extension, if any):

*Cell phone (include area code):

*Parent/Guardian’s Email Address:

*Participant’s E-mail Address:

EMERGENCY NAMES and PHONE NUMBERS DURING WORKSHOP and REHEARSAL HOURS:

In an emergency, I (parent or guardian) can reached at the following additional numbers:

(include area code and extension, if any)

*In the event that I cannot be reached, please call:

*Emergency contact name:

at (include area code and extension, if any)

*Does your child have any health problems, allergies, use an inhaler or take medication of any kind?

YES: NO:

*If YES, please explain:

(Explanation of any health problems or medications.)

*PRIMARY HEALTH INSURER:

*POLICY NUMBER:

(*Please mail photocopy of insurance cards to Broadway Gems Records address below, or bring with copy of registration form to first workshop.)

*Health Insurer Address:

*Street Address:

*City:

*State:

*Postal Code (00000-0000):

*Insurance company or Administrator contact telephone: (include area code and extension, if any)

*My child has permission to drive himself/herself to and from The Broadway At Your School!™ Musical Theatre Workshop & Benefit Concert Program.

Yes: No:

Please read the following Agreement carefully with your child so that you are both aware of the procedures, rules and expectations of Musical Theatre Workshop & Concert Program.

This Agreement is designed to ensure a safe, cooperative and professional environment for all Participants in the Craig Schulman Musical Theatre Workshop & Concert Program.

1. As this program is of very short duration, attendance at all Master Class/Workshops sessions and Concert Music Rehearsals is mandatory. Absence from rehearsal may result in dismissal from the program.

2. If absent from rehearsal for an illness participants are required to learn all missed music.

3. If absent from rehearsal for an illness, participants must notify designated Stage Manager or designated contact person. PLEASE DO NOT tell another Participant; if Stage Manager or designated contact person is not notified, your notification does not count.

4. All decisions regarding musical assignments and selections, solos, features and understudies (if any) will be determined by Mr. Schulman and/or the Music Director.

5. Participants must maintain a good attitude and respect all fellow participants. Respect and consideration for Mr. Schulman, the Music Director, fellow Participants, and anyone connected with, performing in or attending this program, and the personal property of others must be displayed at all times.

6. Participants must bring their own sheet music to Master Class for accompanist. Song must be memorized. Only Broadway, operetta or operatic selections are appropriate. Participants will be provided with music for the ensemble selections for the concert.

7. Participants will provide their own water and snack for rehearsals, and must be responsible for cleaning up after themselves.

8. Participants must bring a tape recorder to rehearsals, as well as fresh and spare batteries and a blank cassette tape.

9. Music need not be memorized, however; participants must be musically prepared for the performance.

10. Members must act in a professional manner at all times, listening and following instructions given by the Music Director, Stage Manager or Mr. Schulman.

11. Inappropriate behavior is not acceptable. Participants displaying any misconduct may be dismissed from the program (no refunds will be given).

12. No one other than Mr. Schulman, the Music Director and Program staff may be present at any rehearsal unless requested and approved by Mr. Schulman or the Music Director.

13. Members must arrive on time for all rehearsals and Master Class/Workshop sessions.

14. Participants must remain at the designated Workshop, Rehearsal and Performance locations until picked up by a parent, legal guardian or car pool, unless written permission from parent or guardian is presented beforehand. Under no circumstances may any Participant leave the premises, unless written, prior arrangements are made with Mr. Schulman. Participants must understand that if they do leave the premises without permission, they may be immediately dismissed from the Master Class/ Concert Program.

15. Extra rehearsals may be added at the discretion of the Music Director prior to the concert.

16. Checks should be made payable to: Broadway Gems Records LLC.

17. The cost for participation in the Master Class/Pops Concert is $195.00.

18. Checks must be accompanied by completed application form.

19. Space is limited. Selection for participation in the Master Class and Concert will be made by Mr. Schulman on a first-come, first-served basis as well as other possible factors.

20. Participation is open to individuals aged 14 to 18 (freshman to senior) years.

21. Checks and completed applications should be mailed to the following address:
Broadway Gems Records, LLC.
P.O. Box 1139, Yorktown Heights, NY 10598

22. As space in the program is limited, fees are non-refundable. (Certain exceptions may be made. Documentation may be required, i.e. – refund for illness would require Doctor’s note. Refunds may be pro-rated.)

23. Parents or guardians, friends and interested observers may be allowed to be present to observe the Master Class and Workshop sessions. Rehearsals are not open to the public.

24. In return for the Participants’ and the Participants’ organization’s help in selling tickets to the Concert, a donation of 20% of the net proceeds from the concert will be made by Broadway Gems Records LLC to benefit a local performing arts organization (i.e. – Your school’s Drama Club, etc.). Recipient to be designated by Mr. Schulman.

RELEASE OF LIABILITY / DISCLAIMER:

I give my permission for the above named minor to participate in The Broadway At Your School! ™ Musical Theatre Workshop & Benefit Concert Program. I agree to pay the non-refundable participation fee in the sum of $195.00 as per this agreement. (If the program fails to reach minimum participation levels, I understand that the program may be canceled and all fees will be refunded.) I agree to review and sign the rules stipulated in the accompanying Agreement with my child. My child will conduct him/herself in a responsible and appropriate manner.

In the unlikely case of injury or suspected injury or illness, I give permission to have my son or daughter treated at a hospital or emergency facility. I agree to indemnify and hold harmless The Broadway At Your School! ™ Musical Theatre Workshop & Benefit Concert Program, Broadway Gems Records LLC its employees and Craig Schulman, as the aforementioned cannot be held responsible for treatment administered by any doctor, nurse or any other qualified medical professional.

I understand that my child’s photograph, video image or any written testimonials may appear on the CraigSchulman.com and/or BroadwayGemsRecords.com websites, or be used for publicity or promotional purposes. I understand that I must be eighteen years or older if I am a student signing this agreement and paying the program fee. I agree to all terms and conditions listed herein.

By submitting this form, I state that to the best of my knowledge, all the information I have supplied is accurate and truthful. I have read and accept the terms and conditions contained herein. I have read and understand the above rules and regulations.

Agreed to and Accepted by:

*Your name:

*Your age:

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This form will be submitted by e-mail. The integrity and security of this message cannot be guaranteed on the Internet. If you are uncomfortable with e-mailing the information contained in this form, please print the completed form, sign it below and mail with your check to: Broadway Gems Records LLC, P.O. Box 1139, Yorktown Heights, NY, 10598, USA

*I accept:

Please print form , fill out and send form with check (or make credit card payment see below) to:

Broadway Gems Records LLC
P.O. Box 1139
Yorktown Heights, NY, 10598, USA

Click here to make credit card payment online

I prefer to pay by check. I will print the application, sign below and mail the completed application, check and copy of my insurance cards.

(*Parent or Legal Guardian Signature)

(*Participant Signature)

(It is recommended that you print and/or save a copy of your completed application for your records.)

This message form contains confidential information and is intended only for use by Broadway Gems Records LLC. If you are not the named addressee (Broadway Gems Records LLC) you should not disseminate, distribute or copy this e-mail. Please notify the sender immediately by e-mail if you have received this e-mail by mistake and delete this e-mail from your system.