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Name:

E-mail:

Cell phone:

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I would like to participate as a:

Team Captain (I will also perform)

Team Captain (coordinator only – I will NOT PERFORM)

Performer (I do not have a team but would like to join one if possible)

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Our show’s title/theme is:

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CONFIRMED performers for this team are:

Myself (if not performing, leave unchecked)

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Team Member 2:

E-mail:

Cell phone:

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Team Member 3:

E-mail:

Cell phone:

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Team Member 4:

E-mail:

Cell phone:

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Team Member 5 (if applicable):

E-mail:

Cell phone:

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We can perform on any date EXCEPT:

April 2 (Tues.)

April 3 (Wed.)

April 4 (Thurs.)

April 5 (Fri.)

April 6 (Sat.)

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Ideally, we would PREFER the following time slot:

early (6:00 p.m.)

late (9:00 p.m.)

either

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We are willing to perform in a venue that allows smoking.

No

Yes

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Comments /requests: