Académique Documents
Professionnel Documents
Culture Documents
Emerson Kelly
General Manager
Direct: (603) 816-2693
emersonk@peacockplayers.org
www.peacockplayers.org
Main: (603) 889-2330
Box Office: (603) 886-7000
2) Completed Forms: Mainstage Registration, Cast & Crew Contract, Medical Information (2 pages),
Consent/Liability Release, Photo Release, Parent/Volunteer Sign-Up
BIOS:
Each cast/crew member is expected to provide a bio for the playbill. Please note, failure to submit a bio by the due date may result in
being omitted from the playbill. Cast bios are limited to 100 words or less. Please include the actors previous performance credits, as
well as their scholastic and personal achievements. All bios are subject to editing for content and length. Bios should be written in the third
person, using the following model as a guide:
ALEXANDRA SOCHA (Ensemble) is proud to be making her Mainstage debut with Peacock Players. Other favorite credits include Spring Awakening, Just So, 42nd Street, Narnia and Elton
John & Tim Rices Aida. She is a sophomore at Nashua High School South where she is an honor student and an active participant in glee club and robotics. Alexandra would like to thank her
family and friends for their constant love and support.
RAFFLE:
For each Mainstage production, Peacock Players organizes a fundraising raffle with show-related merchandise. These production-themed
raffle prizes are donated by the cast/crew members and their families. Please consider donating an item for our concessions display.
MAINSTAGE REGISTRATION
______________
There is a $150 Educational Production Tuition (per student) required for this production.
If you need to make additional payment arrangements, you may contact GM Emerson Kelly at
emersonk@peacockplayers.org prior to or at the initial orientation meeting. Please note, failure to meet these
requirements may result in your dismissal from the production.
Each production tuition includes a free cast member T-shirt. Please indicate youth or adult and size below.
Actor(s) name below should be listed as you wish it to appear on the T-shirt and in the playbill.
You can purchase extra t-shirts at $15 each, please list extra T-Shirt on the name line with the corresponding
size information.
Adult or Youth
T-shirt Size
1
2
3
4
Your support of Peacock Players is critical to keeping our ticket prices reasonable and our tuitions affordable;
making our Mainstage productions and theatre arts education accessible to everyone in our region. Your generous
donations help to maintain the high quality of production and education associated with New Hampshires premier
award winning youth theatre. No gift is too great. No amount is too small. Each and every single contribution is
greatly appreciated.
$ __________
$ __________
$ __________
MEDICAL INFORMATION
(Please submit per student - 2 pages)
Please provide emergency contact and insurance information for each student. In the unlikely case of an
emergency it is crucial that Peacock Players has the necessary information to respond. PLEASE PRINT
CLEARLY. This information is CONFIDENTIAL and will only be used in case of an emergency.
STUDENT INFORMATION
Name:
Date of Birth:
Address:
City:
State:
Home Phone: (
Cell Phone: (
Zip:
)
Email Address:
Relationship:
Address:
City:
Home Phone: (
Place of Employment:
Cell Phone:
Insurance Co.
Work Phone: (
Policyholders Name:
Email Address:
State:
Zip:
Policy #
Please list any allergies (as well as reaction and management of reaction) and/or details regarding medical care:
Food:
Medicine:
Respiratory/Environment:
Latex Allergy?
Yes
No
Please list any known physical/behavioral conditions and current medications that should be made known to a doctor
in case of an emergency:
Cell Phone:
Work Phone:
Please provide any other pertinent medical information. (allergies, chronic conditions, disabilities, medications, health
plan authorization, etc.) Please note Peacock Players staff will not administer any medications if medications are necessary during
rehearsal or show times please contact a staff member to make appropriate arrangements.
I give permission for any Peacock Players representative or medical personnel to treat my child in the event
of an emergency.
YES
NO
(circle one and sign below)
Parent / Legal Guardian Signature
Date / Update
I agree to remain within the building during all scheduled rehearsals and performances, unless specific permission has been granted by Peacock Players staff.
I agree to respect all staff members, cast members and volunteers by keeping my language, behavior, and dress appropriate for the organization at all times.
I agree not to alter my appearance (i.e. haircut, hair color, tanning, etc.) without permission of the production Director.
I am aware that all food or drink (except water) is not permitted in the theatre or rehearsal studios at any time.
I understand that all physical fighting or harassment will result in immediate dismissal from the production.
I understand that the use of alcohol, tobacco and/or drugs at all Peacock Players facilities or events will result in immediate dismissal from the production.
I understand that I may be invited to attend mediation, if I am involved in or witness any disputes while here at Peacock Players, and I agree to help resolve all issues
peaceably and positively.
I agree to keep all windows closed at all times, and not to go out onto the roof at anytime.
I agree to turn off lights, and any electrical appliances (i.e. hair dryers, curling irons, air conditioners, etc.) when not in use.
I agree to respect all other building tenants, productions, rehearsals and classes.
I agree to keep all Peacock Players common areas, offices, rehearsals studios and performance areas clean and orderly.
I am aware that Peacock Players is not responsible for any and all personal items brought into the building (MP3 players, cell phones, cameras, tools, wallet, etc.).
I am aware that eating or drinking (except water) in costume or near costumes is strictly forbidden.
I agree to remain completely silent backstage (and in the lobby) during all technical rehearsals and performances.
I agree to participate in production strike while being actively involved until the entire clean-up process is complete.
I agree to the above terms and will follow and support the rules of Peacock Players. I am aware that the
Educational Production Tuition is non-refundable, and failure to follow the above policies may result in
dismissal from the production. All dismissals will be determined at the discretion of Peacock Players staff.
Student Print Name ______________________________________________________
Student Signature ________________________________________________________ Date ___________
I have read the above student contract and I agree to the above terms. I will encourage my student to follow
and support the rules of Peacock Players. I understand that Peacock Players is a not-for-profit organization
that depends on volunteer involvement and I recognize that it is expected that parents/families volunteer
towards this production.
Parent Print Name ______________________________________________________
Parent Signature ________________________________________________________ Date ___________
PARENTAL CONSENT
(Please submit per student)
I,
, of
(your address) as
parent or legal guardian of
, a minor child, date of
birth
, in consideration of the permission granted to my child or ward by the Peacock Players,
Inc., of 14 Court Street, Nashua, New Hampshire, to participate in any Peacock Players activity, event, travel or
production, I hereby release the Peacock Players, its agents, employees, Board of Directors, or officers from all
liability to the undersigned, and his/her child or ward, for any and all loss or damage, and any claims or demands
on account of any injury to the child or ward, including death, whether caused by the negligence of the Peacock
Players, or otherwise, while the undersigned or his/her child or ward is participating in any Peacock Players
activity, event, travel or production.
The undersigned agrees on behalf of himself/herself and their child or ward to indemnify and hold harmless
the Peacock Players from any loss, liability, damage, or cost, whether caused by the negligence of the Peacock
Players or otherwise.
The undersigned hereby assumes full responsibility for any risk of bodily harm to their child or ward due to
the negligence of Peacock Players, or otherwise, while the child or ward is participating in any of the abovedescribed activities.
I, the undersigned, have read this Release and understand all its terms. I execute it voluntarily and with full
knowledge of its significance.
Date
Relationship to Minor
Peacock Players clearly recognizes the amount of trust and confidence parents place in us once they make the decision to have
their children attend our camp, classes or participate in our productions. We take this responsibility very seriously. Peacock
Players is committed to providing a safe environment for your child.
PHOTO RELEASE
______________
________________________________________________
Signature of the Peacock Players Student
____________
Date
If the above is a minor, the section below must be completed by the parent or legal guardian.
__________________________________________________
Signature of parent or legal guardian
(if participant is under 18 years old)
____________
Date