audition dance`s start up application form

 AUDITION DANCE’S START UP APPLICATION FORM INFORMAZIONI PERSONALI FIRST AND LAST NAME: DATE OF BIRTH: NATIONALITY: ADDRESS (street and country) EMAIL: MOBILE PHONE: SPOKEN LANGUAGES: EXEMPTION OF LIABILITY AND ASSUMPTION OF RISK I acknowledge that my participation in the DANCE’S START UP audition held on ………………… At Leggere Strutture Art Factory, Via Ferrarese 169/A Bologna – Italy may involve risk of accident. I hereby release Leggere Strutture Art Factory, its director, officers and teachers from my liability in connection with any injuries I may suffer as a result of my participation and my performance during the audition, including the loss of any accessory, equipment or personal belonging. The personal information contained in this file will be kecpt confidential by Leggere Strutture Art Factory and its affiliated companies. Only persons who require this information in the performance of their duties will have access to it. The use of electronic equipment such as camera, video camera, cellular phone or any other device to record or take pictures of the audition in part or in whole is strictly forbidden, unless prior authorization has been given by Leggere Strutture Art Factory’s representative. SIGNATURE