MAINSTAGE INFO SUBMISSION FORM

Production

Select the show you have been cast in.

Primary Email

Student Email (If Applicable)

Cast/Crew Member Name

First Name

Last Name

Role (Show or Production Team)

Bio Text (about 75 words or less)

BIO GUIDELINES -Try to keep bio to 50-100 words. -Lake Country Playhouse & Academy reserves the right to edit all bios for space consideration. -Please include your full name as you would like it to appear in the the program -When you write your Bio, please maintain the following formatting order for CREDITS: Lake Country Playhouse, Other Theatre credits, or school credits, Professional credits (if applies) SAMPLE BIO: Katie Berg (Role) - is thrilled to join these incredible vocalists for a one-of-a-kind performance! Favorite credits: SPAMALOT! (Lady Of The Lake) at LCP; The Bridges of Madison County (Francesca), Matilda (Miss Honey), and Big Fish (Sandra Bloom) at WCT; She Loves Me (Amalia Balash) at Forte Theatre Co; and Annie (Star To Be) at Skylight Music Theatre. Katie studied Musical Theatre at NYU-Tisch and UW-Madison. Katie is Founder and Director of the Playhouse Performing Arts Academy in Hartland. Love to my boys!

LCP & Academy Debut

This is my very 1st LCP & Academy production!

Photo Release

As part of the marketing for LCP's Academy programming we take photographs and short videos (30-60 seconds) of our programs which may be used for Lake Country Playhouse & Academy's promotional and development needs. Below we ask your consent to use photographs, recordings or submitted video content of your student for advertisement, marketing, or grant development purposes.

Signature

(Parent/Guardian Signature for cast members under the age of 18)

First Name

Last Name

Emergency Medical Information

Please list any medical conditions, allergies (including food, medication, or environmental), or other health concerns we should be aware of in case of an emergency. If none, please write "None." This information will be kept confidential and only used to ensure your safety during rehearsals and performances.

Emergency Contact

Please provide the name, relationship, and phone number of at least one emergency contact we can reach during rehearsals or performances.